Personal Health Questionnaire

Your Personal Details

Your Lifestyle

Your Aims

Your Health/Medical Information

Important Information and Client Release Statement

Ver 1.1
Please advise your instructor  before commencing any session, if for any reason, your health or your ability to exercise changes. 

Pilates exercises are very safe, but with all forms of exercise, it is prudent to consult your doctor before starting Pilates sessions. 
If you have any doubts about the suitability of the exercises, you should refer back to your medical practitioner.  The instructor cannot accept liability for personal injury related to participation in a session if:
-           Your doctor, on health grounds, advised against such exercise
-           You fail to observe instruction on safety and technique
-           Such injury is caused by the negligence of another participant in the class/studio

Exercise should be performed at a pace which feels comfortable for you.  PAIN is the body’s warning system and should NOT BE IGNORED.  Please inform your instructor immediately if you feel any discomfort during a session. 
 
I understand that IntensysLife Pilates exercises involve hands-on correction and I hereby consent for my instructor to work in this way.   
*Update* During the coronavirus times, a safe distance shall be maintained at all times and hands-on correction will not be used
( unless absolutely necessary in the event of safety concerns).

I confirm that I have read and understood the above advice and the information I have given is correct. 
 
I willingly participate in the practical exercises at my own risk.  I have no physical restrictions, disabilities or any predisposition to sickness or injury that may be aggravated or adversely affected as a result of my participation.  I take full responsibility for any injury, loss or damage to my person or property that may arise directly or indirectly from my participation in the exercises.  I will not seek to penalise, prosecute or claim compensation from the coach for any injury, loss or damage.  I understand that photographs may be taken during classes for promotional purposes, and that I can request not to be included in any photographs.
 
I understand that the data on this form will be stored safely and used solely by IntensysLife according to GDPR regulations and for my benefit for as long as I continue to take Pilates sessions or classes with IntensysLife.  I understand that I have full access to view what data is held by IntensysLife about me, and that I can ask for this data to be corrected or deleted at any time.