Pilates Private/Duet Intake Form
Please complete this form to help us understand your exercise and health background and your goals for your Pilates session and wellness journey.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please describe any current or past injuries that might help us plan your session.
*
If you would like, please share your movement and exercise forms on a weekly basis and or what you used to do and would like to get back to.
Do you have any medical concerns that we should be aware of? Please specify.
Have you practiced Pilates before?
*
Yes, regularly
Yes, occasionally
No, I am new to Pilates
What are your primary goals or expectations from Pilates?
Is there anything else you would like us to know?
Submit
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