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Private Classes Enquiry Form
(Next to Upper Thomson TEL Station, EXIT 4)
93 Soo Chow Walk
#02-01 Singapore 575386
Please fill up the form below if you like to enquire for private sessions, we will match you with an instructor and respond to you within 48 hours. Thank you.
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Name (first, last name)
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Your answer
Mobile Phone
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Your answer
Email
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Your answer
Address
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Your answer
Gender
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Male
Female
Birthdate
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MM
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DD
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YYYY
How did you hear about us? Who referred you to us?
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Your answer
Client referral (Name)
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Your answer
What is your occupation? What does your typical day involve physically? e.g. sitting at computer, lifting,..
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Your answer
What are your goals? What do you want most from the program?
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Your answer
Are you exercising currently? And how important is exercise to you?
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Extremely important
Very important
Somewhat important
Not so important
Not at all important
Other (please specify)
Describe your current physical condition?
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Your answer
Do you have any injuries, aches or pain? (recent or old). Please describe them.
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Your answer
Are there any other health concerns? e.g asthma, diabetes, high blood pressure, medications..
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Your answer
Any surgeries done previously or currently? Please describe condition and surgery done.
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Your answer
Do you have osteoporosis/osteopenia?
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Your answer
Are you presently doing other kinds of therapy? e.g. massage, physiology, chiropractic..
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Your answer
Are you or were active in any sports, exercise programs, physical activity? Please describe.
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Your answer
Have you trained with a Pilates Instructor before? If yes, where and when?
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Your answer
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