New Client Registration
Health Profile Form

 

Please fill out form below or download registration here and bring on your first session.

Name *
Name
Address *
Address
Cell Phone *
Cell Phone
Work Phone
Work Phone
Home Phone
Home Phone
Date of Birth *
Date of Birth
Gender *
Emergency Contact *
Emergency Contact
Phone *
Phone
ARE YOU NEW TO PILATES?
DO YOU EXERCISE OR PARTICIPATE IN ANY OTHER PHYSICAL ACTIVITY? *
Do you smoke? *
How is your overall health? *
Any health conditions could affect your training. Please provide any necessary details below. Please also discuss any pertinent health issues with your trainer.
Diagram
Body Issues
Referring to the diagram above, check the following numbers that correspond to the location on the body which you may have issues:
Please provide a brief description of the body issues you checked above
Get ReFormed Pilates Center Terms and Conditions:
1. To the best of my knowledge all of the above statements are TRUE. 2. I understand that all exercise may have certain risks. 3. I understand that Pilates is nota substitute for medical treatment and therefore if I am unsure about the suitability of exercise which I am performing, I should refer back to my Doctor. 4. I understand that all exercises should be performed at a pace that is comfortable for myself and anyPAIN during and after the session should not be ignored.I understand that it is MY responsibility to inform the instructor of any such discomfort before, during and after the session. 5. I release from all liability Get ReFormed Pilates Center, LLC **Rebecca & MC Swieczkowski** Associate Trainers & Instructors conducting business within the Get ReFormed Pilates Center.
Booking & Cancellation Policy
BOOKING: Sessions are Initially booked in Advance by Contacting Rebecca@getreformed.com /Text 469-964-8481. Auto-Email Appointment Reminders are sent 5 Days in Advance-Respond only if there are Changes. The Appointment Schedule is based on Private/ Semi-Private RECURRING Weekly Appointments. When conflicts arise, Clients may Reschedule their Appointment/ Semi-Private Group to another Day. Openings for Single Appointments are always available due to the nature of Client Cancellations/Travel. Cancellation: Clients must notify the Trainer 12 Hours in Advance for Early (No Charge) Cancellation. Trainers will use compassionate discretion in Late Cancel Charges for extenuating circumstances. Please notify Trainer in Advance of any Future. Cancellations due to Travel, Personal Obligations. Communicate with Trainers by TEXT (not email) for late arrivals or late notice changes in Appointment. Rebecca: (469) 964-8481 Charles Stefan: (214) 604-4327
I agree *
Date *
Date