Pregnancy Health Screening & Consent Form

Before attending a class, please complete this short health screening and consent form so I can support you safely and effectively in your recovery.

    Personal Information





    Pregnancy Details


    YesNo

    YesNo

    YesNo

    YesNo

    Medical History

    Exercise History

    YesNo

    Consent & Acknowledgement

    • I confirm that I have disclosed all relevant health information and understand that it is my responsibility to inform my instructor of any changes.

    • I acknowledge that while every care will be taken, participation in exercise is at my own risk.

    • I confirm that I have consulted with my GP/midwife and have no medical reason to avoid safe, modified exercise during pregnancy.

    I confirm that I have read and understood the above, and I consent to participate in pregnancy-safe exercise.


    Legal & Marketing

    I confirm that I have read and agree to the Terms and Conditions and Privacy Policy.

    Yes, I would like to keep in touch and receive news, exercises, health tips & recipes

    🔒 Your information will be kept strictly confidential and used only to ensure safe and appropriate exercise.