Description
A completed Health Questionnaire is required prior to your first session. Additionally, it is your responsibility to update the questionnaire if there are any changes to your health, contact details (including address and phone number), or emergency contact information. This is essential for your safety and well-being during the sessions.
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Health and Safety Questionnaire – Physical Activity Readiness Questionnaire (PAR-Q)
1. Name:
2. DOB:
3. Occupation:
4. Emergency Contact:
Q1) Do you suffer from any medical/health conditions that might affect your ability to exercise?
Q2) Do you have any specific problem areas that cause you pain (even if mild)?
Q3) Have you ever been advised by a doctor not to exercise?
Q4) Have you recently had an illness or operation? Please provide details.
Q5) Are you pregnant?
Q6) Please describe your experience of Pilates to date?
Q7) What are you hoping to achieve/what are your goals?
Q8) Is there anything else I need to know?
Please note: If anything changes regarding your health or ability to exercise, please inform Katherine immediately (before/during a session).
If there is any query regarding your health and/or ability to exercise, you are advised to seek medical advice as soon as possible. By signing this form, it is assumed you have taken all necessary steps to ensure your health and safety to attend a session with Janet. She accepts no responsibility based on this.
Signed: ______________________
Date: ______________________
Please sign and return to Katherine kittid@hotmail.co.uk
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