07980 305 276 info@elizabethnadine.com

Health Registration Form

If you are new to my classes, please kindly complete this form prior to attending class.

If you are an existing client and have already completed this health form within the last 12 months, please complete it again if there are any changes to your health.

Please note that all clients are required to kindly complete this form every 24 months.

    Class you would like to sign-up to (required):


    Have you practised yoga or pilates before? Please give details of how long, what style of yoga/pilates etc:


    What do you currently do to keep fit, and how often?


    How would you currently describe your fitness, flexibility and strength?


    What are you hoping to gain from the class?


    Do you have any current, or historic, back or neck issues, injuries or pain?
    YesNo
    If so, please state details:


    Do you have any injuries, illnesses, medical conditions, or disabilities, current or historic, that could potentially impact your workout?
    YesNo
    If so, please state details:


    Are you pregnant or have you had a baby in the past 9 months?
    YesNo
    If yes and you are pregnant, please confirm how may weeks pregnant and your due date, and if postnatal, please confirm your baby’s birth date and any other details that may be helpful for the purposes of the class (e.g. c-section, tears, stiches etc.):

    If yes, please confirm that your Doctor has given you the all clear to do Pilates or Yoga?
    YesNo


    Are you taking any form of medication that may have some bearing on your yoga or pilates practice?
    YesNo
    If so, please state details:


    What areas of your health, fitness or wellbeing would you most like to improve?


    How did you hear about Elizabeth Nadine Classes?