top of page

Berrylands Pilates

Postnatal Health Questionnaire Form 

The following information is to ensure the exercise is as safe and appropriate for you as possible. Please read the questions carefully and answer each one honestly. (All answers will be treated with the strictest of confidence).

What type of delivery did you have ?
Did you have episiotomy?
Did you have any stiches ?
Have you had your 6-8 weeks postnatal check up?
Do you have or you ever had any of the following conditions?
Have you been diagnosed with or have a treatmnet the following conditions (Asthma, Diabetes, Epilepsy, Hernia,Stroke, Cancer, Depression)?

Thanks for submitting!

bottom of page