Class Medical Form - Annual Update

STRICTLY PRIVATE AND CONFIDENTIAL

Only complete if there are any changes
Only complete if there are any changes
Only complete if there are any changes

Exercise Class Aims

General Medical Questions

Health Questionnaire

Lifestyle

For your information

Please wear clothes that can you can move freely in.  If you are attending Pilates classes please wear socks to the class otherwise please wear trainers / sport shoes.  We have Pilates socks, Pilates pillows and a range of other small equipment available to buy in the clinic if you wish to purchase your own equipment for use in the class or at home. 

Exercise Class Participation Informed Consent

The exercise class may be a mixed ability class.  You will begin at a low level and you will be advanced in stages depending on your fitness level.  You agree to work at your own level and with guidance from your instructor. We stop the exercise session because of signs of fatigue or excessive strain.  It is important to realise that you may stop when you wish because of feelings of fatigue or any other discomfort. 

There exists the possibility of certain dangers when exercising.  They include abnormal blood pressure, fainting, irregular, fast or slow heart rhythm, and in rare instances, heart attack, stroke or death.  Whilst every care will be taken, it is impossible to predict the bodies exact response to exercise.  Every effort will be made to minimise these risks by evaluation of preliminary information relating to your health and fitness and by observations during exercising.  Emergency equipment and trained personnel are available to deal with unusual situations that may arise. 

I understand that with certain conditions a certain degree of undressing may be required during the assessment and the instructor will explain this to me at the time.  I understand the Exercise programme will take into account details given by my health questionnaire and assessment.  Therefore, this programme of exercise should only be undertaken when in the class, or when I have been given specific instructions to exercise on my own. 


THIS INFORMATION IS PROTECTED BY GENERAL DATA PROTECTION REGULATION

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