Tell us about you. Name * First Name Last Name Email * Phone * (###) ### #### What services are you interested in? * Pilates Sessions Pilates Teacher Training Group Classes How did you hear about us? * Referral Social Media Community Event Birth Date * MM DD YYYY What is your goal and how can we help you? * Health History Please complete the following questions. History of heart problems, chest pain or high blood pressure? * No Yes Any chronic illness or condition? * No Yes Recent surgery or procedure within the last 12 months? * No Yes Do you experience any major discomfort during exercise? * No Yes Are you pregnant or have you been pregnant within the past three months? * No Yes Do you have any past or current injuries that might impact your movement experience? * No Yes Thank you so much for filling out your intake form. Our teachers love getting an idea of your needs before your first session with us.
