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Health Questionnaire

Please fill out the form below before your first session.

Date of Birth
Day
Month
Year
Please read the questions carefully and tick yes to those that apply.

If you have answered YES to any of the questions above we strongly advise that you consult your medical professional before you start classes with Saffron Pilates. Saffron Pilates reserves the right to request that you provide consent from your medical professional confirming your ability to undertake activities with Saffron Pilates.

 

If you have answered YES to any of the questions above, please provide further relevant details below. 

Important Information and Informed Consent

Whilst every care will be taken to ensure your safety, it is impossible to predict the body’s exact response to exercise. Therefore, it is important that you provide the correct information in the health questionnaire to minimise any risk. 

 

If you are pregnant or could be pregnant, we strongly advise that you check with your doctor/midwife at regular intervals if it is still okay to exercise. 

 

Please check with your medical professional if you are uncertain about the suitability of the exercises. While we are experienced teachers, Saffron Pilates cannot accept any liability for injury related to participation in a session if your doctor has not given you clearance to exercise or you fail to observe instructions on safety and technique. 

 

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

 

Please tell the teacher if you feel any dizziness, nausea or pain during the session, or you felt discomfort or pain after a previous session. Sit and rest and drink water until the feeling passes. If you feel you need to leave the room please do so. 

 

Data Protection

All information Gathered is treated as confidential and will not be shared with a third party. Data collected on this form is kept securely and only viewed by the teacher of the class. Your data is kept for 7 years after your last session with Saffron Pilates as stipulated by our insurance company

 

By signing this disclaimer you are agreeing to your email/phone number being used by Saffron Pilates to inform you of class changes and service updates relating directly to the services you have booked or enquired about.


Occasionally we may email/text giving information with regards to new classes and services, please choose where appropriate:

Opt In/Opt Out

I agree and acknowledge that I am fully aware that participation in the activities with Saffron Pilates involves risks and I accept all the risks of participating.

 

I understand that the exercises involve hands-on correction and I hereby consent for my teacher to work in this way. 

 

I understand that relevant sections of any of my medical notes and data collected during the activities may be looked at by the instructor where it is relevant to my taking part in a session and I give permission for these individuals to have access to my records.

 

I confirm that I have read and understood the above Important Information and that the information I have given is correct.

 

I confirm that I have read and accept the above conditions and guidelines and I will be bound by them. 

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