Psalm Pilates
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Step two

New Client Registration

Thank you for taking the time to complete this. What you share here is what makes a safe, personalised and effective Pilates experience possible, tailored to your body, your goals and your life. All of it stays confidential.

Your details

First and last, for example Jane Doe.

Only needed if you would like sessions at your home.

First and last, for example Jane Doe.

Preferred method of communication *

Choose any that suit you.

Pilates and activity history

Write N/A if this is your first time.

Are you currently participating in other forms of exercise? *

How frequently do you exercise per week? *

How would you describe your overall fitness and movement confidence? *

Injury and medical history
Are you currently experiencing any pain, injuries, or physical limitations that may affect movement? *

Have you had any surgeries or significant medical procedures in the past 5 years? *

Do you notice shallow breathing, breath-holding during activity, or difficulty taking deep breaths? *

Do you experience pain in any of the following areas?

Rate each area from 0 for no pain to 10 for the worst pain. Leave at 0 if there is none.

0
0
0
0
0
0
0
Do you have any diagnosed conditions? *

Check all that apply.

Are you currently pregnant or postpartum? *

Are you currently under a doctor's care for any condition? *

Goals and expectations
What are your primary goals for beginning Pilates at this time? *

Select all that apply.

Pain, stiffness, weakness, balance, or anything else.

Floor level preferences, music volume, lighting, or anything else. Write N/A if none.

Agreement
May reference photos or videos be taken and kept for posture and movement analysis? *

Shared only with you, and you can withdraw consent at any time.

I understand that Pilates is a form of physical exercise that requires physical exertion and may involve inherent risks. I confirm that the information provided above is accurate to the best of my knowledge, and that I will inform my instructor of any changes to my health or physical condition.

Your answers are used to plan your sessions and to reach you or your emergency contact. They are never sold or shared. See the health and waiver policy for detail.