Intake, conversational form
Pilates intake template
A new client intake for a pilates studio covering experience, classes, frequency, health conditions, pregnancy, clearance and health fund.
11 questions, 10 required, as a conversational form
Use this template opens a copy in the form builder after you sign in. Adapt it with AI opens the generator with this template chosen, so you can describe your business and get the questions rewritten for it.
Every question
How much pilates have you done? (required)
Single choice: None at all, A few mat classes, never on a reformer, Some reformer classes, more than a year ago, Currently doing mat classes elsewhere, Currently doing reformer classes elsewhere, Trained in pilates myself
Which classes are you interested in? (required)
Multiple choice: Reformer, all levels, Reformer, beginners only, Reformer, advanced and jumpboard, Mat class, Clinical pilates, one to one, Pregnancy class, Postnatal class with babies welcome, Over sixties and bone health class
How often would you like to come? (required)
Single choice: Once a week, Twice a week, Three or more times a week, Casually, whenever a class suits
Injuries, surgeries and anything that still gives you trouble (required)
Long answer
Do any of these apply to you? (required)
Multiple choice: Osteoporosis or osteopenia, A disc injury or ongoing back pain, Hypermobility, or joints that dislocate, High blood pressure, A recent surgery, in the last six months, A shoulder that comes out or catches, Vertigo or dizziness when lying back, None of these
Are you pregnant, or in the first year after birth? (required)
Single choice: No, neither, Pregnant, first trimester, Pregnant, second trimester, Pregnant, third trimester, Under six weeks after birth, Six weeks to six months after birth, Six to twelve months after birth
Have you been checked by a womens health physiotherapist? (required)
Single choice: Does not apply to me, Yes, and I was cleared for exercise, Yes, and there were things to avoid, Booked, but not seen yet, No, and I would like a referral, No, and I am not planning to
Will you be claiming on a health fund? (required)
Single choice: No, paying myself, Yes, on extras cover for clinical sessions, Not sure, please explain at the desk, Using an NDIS plan, Coming on a workplace wellbeing program
How did you hear about the studio? (required)
Single choice: A friend or family member, Walked or drove past, Searched online, Instagram, A physiotherapist or GP suggested it, A workplace program
What would make this worth it for you?
Long answer
How does the studio reach you? (required)
Profile
What you fill in
- [Phone]
- [Your company]