Health Registration Form

If you are an existing client and have completed our health form within the last 12 months there is no need to complete this form again, but please notify me of any changes to your health.

For new clients, please complete the form on the link below before attending class:

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:

Physically what would you say your strengths are and your weaknesses?

What are you hoping to gain from the class?

Do you have any illness, medical condition or disability?
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 would you identify as the major cause of stress in your life at the moment?

What do you usually do to relieve this stress?

How did you hear about Elizabeth Nadine Classes?