top of page

Body Mind

Design

HOME
- Welcome Page
Body
Mind
Programs
- Foundations
About
Contact
Plans & Pricing
More

Use tab to navigate through the menu items.

Acerca de

Pre-Screening

Health & Fitness Pre-Screening Questionnaire

First Name

Last Name

Email

Phone

Date of Birth

Do you have any medical conditions or injuries that impact your ability to safely exercise?

No

Yes

If 'yes' please detail any medical considerations below including any medication or precautionary measures given by your doctor or health specialist:

Please detail any injuries or pain points that you have sustained in the past or that currently impact your ability to move:

Please detail your experience with exercise, including how long you have been exercising and what sort of physical activity you have been undertaking in the last 6 months:

Which programs are you most interested in?

Restore

Strong

Lean

Athletic

Mix

Solo

Which days do you prefer to train on?

M

Tu

W

Th

F

Which time works best for you?:

Is there anything else you would like to share with us regarding specific goals or considerations?

I declare that the information I’ve provided above is accurate & complete

I acknowledge that all exercise involves inherent risk and that whilst all care and precaution will be taken to avoid it, there is still a chance that injury may occur as a result of exercising. I agree to assume full responsibility for this risk and hereby release from liability Body Mind Design and any associated Personal Trainers for any accidental injury or illness which I may incur as a result of my participation in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this exercise program.

Terms & Conditions

All Body Mind Design programs are non-refundable however, you may choose to transfer your program and any remaining sessions to another person within the program period.

A 24-hour notice is required for any session cancellations otherwise the associated session is forfeited. Sessions cancelled outside of the 24-hour notice period can be shifted to later within the current week or the following week if a session time is available but may not be accrued beyond that.

Sessions will go ahead as scheduled and will only be cancelled due to severe weather or unforeseen circumstance (such as injury of trainer or emergency). Any cancelled sessions will be shifted to an alternative time at the next possible opportunity.

I accept terms & conditions

Initials

bottom of page