Movement & Wellness Assessment

Please complete this short form before your first one-on-one yoga or Pilates session. Your answers help me plan a session that is practical, supportive and appropriate for your body.

Please note: This form is for yoga/Pilates session planning only. It is not medical diagnosis or treatment. If you have pain, a medical condition, recent injury, pregnancy/postnatal considerations, dizziness, chest pain, or any concern about exercise safety, please seek medical clearance before your session.

1. Your Details

2. What Are You Coming For?

3. Safety and Body Check

Tick any areas that may need care or modification.

Tick any that apply so I can plan safely.

4. Movement Snapshot

What tends to feel challenging?

5. Quick Self-Rating

1 = needs support, 5 = feels confident.

6. Aerial Yoga Check

7. Preferences and Consent

Assessment submitted successfully

Thank you, your assessment has been submitted.

I will review your answers before your first one-on-one yoga/Pilates session.

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