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Medical
Questionnaire

*For New Members

Medical Questionnaire

Please fill out the following form to help us understand your physical condition.

Have you been hospitalized in the last 12 months?
Are you currently suffering from a medical condition, illness or injury?
Gender
Do you have kids?
Have you ever done Pilates before?
Do you suffer from:
Have you ever been diagnose with:
Are you pregnant?
Have you been pregnant in the last 6 months?
Are you taking any drugs or medication which may affect your ability to exercise?
Are you seeing any other health practitioners?

Thanks for submitting!

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