New Client Intake FormPlease complete this form prior to your first session. Name * First Name Last Name Email * Phone * (###) ### #### Birth Date MM DD YYYY Emergency Contact Name & Phone Number * Are you new to Pilates? Yes No Do you have any of the following medical conditions? * Osteoporosis High Blood Pressure Low Blood Pressure Pregnancy Scoliosis None of these Do you experience chronic pain or have any conditions not listed above? FOR PRIVATE CLASS STUDENTS What are your goals for private Pilates instruction? FOR GROUP CLASS STUDENTS What are your goals for joining group classes? Please describe your previous experience with Pilates classes. How did you hear about Composition Pilates? Release of Liability * By agreeing below, I acknowledge that I have read the Waiver of Liability at https://www.compositionpilates.com/waiver-of-liability and have provided accurate and complete information to the best of my knowledge. I understand that Pilates exercises may involve physical activity that can pose inherent risks, and I agree to follow the instructor's guidance and listen to my body. I understand that it is my responsibility to notify the instructor of any changes in my health or physical condition before or during a class. I agree Thank you for completing the new client intake form!
