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Contact Info

    




Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
E-Mail:
Day Phone:
Evening Phone:
Questions and/or
Comments:

How did you find out about Beau Corps Studio?
Would you be interested in a complimentary session in a semi-private setting?
Yes    No
What hours are you available for sessions?
 Days (9am-3pm)
Evenings (4pm-8pm)
Do you have any injuries or health problems?
Yes    No
If yes, please check:
 Arthritis
Scoliosis
Joint Pain
Back Pain
Gender:
Male    Female
Age:
Weight:
Height:
Desired Weight:
Do you work out presently?
Yes    No
If yes, please check:
 Walking/Jogging
Weight Lifting
Yoga
Dance
Aerobics
Tennis
Skating/Roller Blades
Other
What are your goals?
 Toning
Flexibility
Strength
Alignment
Pain Reliefs
Therapy for an Injury
Weight Reduction
Improved Posture
Have you exercised on Pilates-type equipment such as the Reformer or the Cadillac?
Yes    No
Have you taken a Pilates based floor/mat class?
Yes    No

 


 

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