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Medical Form
Have you suffered, or do you suffer, from any of the following:
Are you pregnant?

Thank you completing the form.  

DECLARATION.  By submitting this form I acknowledge that I am fully responsible for:

  1. monitoring my capability to participate in any exercise session.

  2. advising CLAIRES PILATES of any health or medical conditions that may affect my participation.

I have answered the questions accurately and to the best of my ability.

I understand the contents of this questionnaire.

Thanks for submitting!

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