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Medical form 2022/23
Please could you complete the attached form before starting working with Sandhya thank you.
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Email
*
Your email
Name
Your answer
Telephone number (optional)
Your answer
Age
40's or under
50's
60's
70 +
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Whats the reason you want to come to a session? what do you hope to gain?
*
Your answer
Please list below any medical or physical conditions / weak areas and if you have any long term covid issues
*
Your answer
What's the biggest frustration about your injury / medical condition? (if appropriate) and If you have been to see a chiro / dr / physio regarding an ongoing injury/ condition please give details below
Your answer
How did you originally hear about the class
*
Google
Recommendation
Keynsham Voice
Wellbeing college
Poster
Facebook
Other
can't remember
Option 9
Other:
Required
Which class will you be attending?
Monday 5.30 Pilates
Tues 10.30 relax tone and stretch
Wed 10.50 Meditation
Thursday 5.30 Yoga
Wed 9.35 Pilates
121 session
Wellbeing college course
https://www.wellbeingcollegebanes.co.uk/Calendar
Sunday retreat
Pilates & Relaxation challenge online
Other:
If you previously attended a class do you have any comments / reviews on the class and how it has benefited you?
Your answer
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