Client Assessment Form
  • Please take the time to fill in this form so I can get to know you as an individual. 
  • The following information will help us to know and understand you better. 
  • Please note this information will remain confidential. 
  • It is advised that you seek medical attention prior to the beginning of the practice of Pilates if you suffer from any health condition or have an injury. 
  • A referral from your medical or health care professional may be requested. 
  • Please bring any relevant x-rays to your assessment session. 
Name *
Surname *
Email *
Phone number *
Emergency Contact Person and Number *
ID Number  *
Date of Birth  *
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Occupation *
Address  *
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