Example Client Questionnaire

Pilates is a safe way to exercise for almost everyone. Below is an excerpt from my “new client questionnaire.”

If you answer no to these question then you can be reasonably sure that you may take part in a group Pilates class. If you answer yes to any of the below, this does not necessarily mean that you cannot take part in the exercise programme, but please gain medical advice and approval beforehand. One-to-one sessions may be more appropriate. Contact Alex for the full questionnaire.

• Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

• Do you ever feel pain in your chest when you do physical activity?

• Have you ever had chest pain when you were not doing physical activity?

• Have you had a stroke?

• Do you ever feel faint, have spells of dizziness or lose consciousness?

• Do you have a joint or bone problem (eg back, knee, hip) that could be made worse by exercise?

• Have you ever been told that you have high or low blood pressure?  

• Are you currently taking any medication of which the instructor should be made aware?

• Are you (or is there any possibility that you might be) pregnant or have had a baby in the last 6 months? *

• Do you have asthma or have ever suffered from shortness of breath at rest or with mild exertion?

• Do you suffer with Diabetes?

• Do you know of any other reason why you should not do physical activity?

*If you answer yes to this question only, please contact me for the Pre/Post Natal client forms.