Fitness with Jo - Application form

To get started fill in the application form and click the submit button below.

NAME:

DATE:

How did you hear about Jo Larkin? Who referred you?

Do you have any injuries, aches or pains (recent and old)? Please describe them.

Are there any other health concerns? e.g. asthma, diabetes, high blood pressure, medications etc.

Are you presently doing any other kinds of therapy? e.g. massage, physio, chiropractic etc.

Are you or were you active in any sports, exercise programs, physical activity? Please describe.

Have you had any past training in the pilates method of movement? If yes, where?

What is your occupation? what does your typical day involve physically? e.g. sitting at computer, lifting etc.

What are your goals? What do you want most from this program?


TERMS AND CONDITIONS
All sessions must be used within 6 months of purchase.
A cancellation fee will be charged at the total price of the session if missed or cancelled without 24 hours notice. If you have purchased a block of sessions the missed session will be deducted from the block. If a single session has been missed the next session will be double the cost.

Tick box below to confirm you agree to the above Terms and Conditions and to make known in advance any medical conditions which may affect your training and that results are dependent on your own compliance and commitment to the program.

fitness with jo - application form