Health Screening Form

All new participants must complete a screening form before commencing classes. Doing so enables us to best ensure your safety during classes, and to take into consideration any health issues you may have. It is also an insurance requirement for us to screen new participants. Completing this secure online form prior to your first class is the quickest and easiest way of doing so. Alternatively you may download and print a PDF version, and bring it with you completed to your first class. Data protection: please read our Privacy Statement and Terms and Conditions before completing this form.

First some basic details please:

You may optionally provide us with an emergency contact:

An overview of your health status please:

Please check all current and past health conditions that apply, or select 'None' if applicable. If you have any of these conditions, you may be required to contact your GP before undertaking classes.

And finally just a few quick questions:

Approximately one email every two to four weeks, including important information such as holiday dates. We will not pass on your email address to anyone else, and you can opt out at any time.
We fully respect your right to privacy and comply with UK Data Protection law. We will always ask before taking any images, and you can opt out at any time.

Please click the ‘Submit’ button below to send us your health screening.

Jane Mackenzie M.A.

Level 4 Pilates Instructor

Level 4 Pilates Therapist

Telephone: 07703 792388
Email: j@janem.co.uk

WhatsApp chatJane on WhatsApp

 
Group 1-1 and online Pilates classes, insured by FitPro

 
Jane Mackenzie group and online Pilates instructor, CIMSPA Practitioner
 

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Folkestone Hythe Sellindge Pilates instructor Jane Mackenzie

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