Wrist Pain, Elbow pain, Finger pain, Manual therapy, Rehabilitation, Accident, Illness therapy Dublin

Your Name:

Your Address:

Your email address:

Contact No.:

Have you attended Pilates classes before? Please describe level

Have you any injuries? (Recent or old). If so, please describe

Do you suffer from back pain?

Do you have any other health concerns?
E.g. Asthma, diabetes, high blood pressure, medications etc.

Are you presently attending a physiotherapist
or another professional regarding treatment?

Are you presently active in any sports or exercise program?

What is your occupation? What does your typical day involve physically?
E.g. Sitting at computer, lifting etc.,

What do you hope to achieve from attending this class?

Please tick your preferred method of contact:

email
post
phone

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