Terms & Conditions - click here

Name *
Name
Address *
Address
Phone
Phone
What are your health and fitness goals?
What activities/ exercise are you currently doing?
If Post Partum, Have you been cleared to exercise by your LMC?
Do you have any pelvic pain and/or abdominal separation from pregnancy? if so, please explain.
Do you have any medical conditions that may affect exercise? eg. Asthma, diabetes, arthritis, carpal tunnel etc.
Do you have any injuries (past or present)? eg. lower back pain, joint pain, surgeries etc.
I have read & agree to all of the terms & conditions set out on the Terms & Conditions Online 10 WK webpage
(See the terms & conditions link at the top of the 'FMP Online Questionnaire' page (above this form)