Intake form

Please complete this intake form prior to your first visit. If you have not yet registered, please do so by booking online or contacting the studio.

 
 
Name *
Name
Home Address *
Home Address
Phone *
Phone
Describe your level of pilates experience *
Please list all concerns.
  • Tone and strengthen musculature
  • Increase flexibility and range of motion
  • Improve posture and body alignment
  • Relieve back and neck discomfort
  • Improve balance and enhance circulation
  • Alleviate overall tension, stress and fatigue
  • Prevent and rehabilitate injury
  • Enhance performance in other physical activities
  • Increase vitality in your daily life
Please read the following and check the boxes for your acceptance *
Union Pilates Policies *
  • All Lessons and classes are 55 minutes in length. The hour begins at the scheduled appointment time, not at time of arrival.
  • Form fitting attire should be worn, preferably black, so proper corrections can be made. No shoes are allowed in studio space. Bare feet preferred. Socks are OK.
  • Insurance billing is not available - receipts only.
  • Studio reserves the right to assign a substitute teacher.
  • All lessons and classes must to be paid in advance.
  • Please notify us of any changes in your health/ medical condition.
  • If a duet student cancels within 24 hours, their partner must also cancel or choose to pay for and attend a private lesson.
  • If a duet student cancels with less than 24 hours notice, they will be charged in full. Their partner may still attend at their regular duet rate.
  • Please arrive 5 minutes prior to your start time and be respectful of volume in the waiting area while classes are in session.
Emergency Contact *
Emergency Contact
Relationship
*
Phone