COVID-19 Supplementary Questionnaire
(Form CVSQ 2021 Update)

Completion of this form is required while government restrictions remain in place. It is supplementary to the standard Core Control Pilates Enrolment Form and only needs to be completed and submitted in advance or your first visit after reopening. After completion please simply click 'submit'. There is no need to print or email it separately. Thank you.

IMPORTANT:

If you have recently developed, or currently still have, any of the following symptoms PLEASE DO NOT COME TO CLASS. You should book a test as soon as possible and follow NHS advice to stay home until you receive the result. Please call 111 for further advice.
1. A high temperature
2. A new, continuous cough
3. A loss or change to your sense of taste or smell

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Name *
Address: *
Mobile Phone Number: *
Date of Birth: *
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Email: *
Have you had, or suspect you have had COVID-19 Coronavirus? *
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