top of page

Health and Safety

 At LYC Pilates, your safety and comfort is paramount. 

We can modify exercises to suit your individual needs, as required, to ensure you have a safe and effective workout in each and every session.

 

 To facilitate this, please fill out the form below with detailed information regarding your health, injuries, and any relevant conditions. This will help us ensure your safety during our sessions and allow us to effectively support you in achieving your goals and enhancing your recovery journey.
 

Medical form

Contact

Birthday
Day
Month
Year

Pregnancy

Are you currently pregnant?
Yes
No
If no, have you given birth in the last year?
Yes
No
If yes, please check those that apply to you

Medical conditions & injuries

Do you have an injury or medical condition?
Yes
No
Are you taking pain medication?
Yes
No
Are you taking any other medication?
Yes
No
Are you currently under medical care?
Yes
No
Due to be
If yes, please select those whom you are receiving care from?
Have you been advised against taking part in exercise by any healthcare professionals?
Yes
No
Have you had surgery in the last 3 years?
Yes
No
Have you got a surgery planned whilst attending LYC Pilates?
Yes
No
Have you provided LYC Pilates with signed consent by a healthcare professional that it is safe for you to partake in Pilates?
Yes
No

Informed consent

I declare that I have read the Medical Questionnaire and have completed it to the best of my knowledge. I agree that my body is my responsibility and I will let my instructor know if I experience any pain or discomfort. I acknowledge that if the instructor feels I am no longer fit to participate they will request I discontinue the program.

Date
Day
Month
Year
Facebook Cover Photo.png

© 2023 by Love Your Core | All rights reserved

bottom of page