Name *

First Name

Last Name

Your date of birth *

MM

DD

YYYY

Your mobile number *

(###)

###

####

Are you looking for in-person or virtual/online sessions? *

In-person

Virtual/Online

Combination of both

How did you hear about Effloro Pilates or Angie? *

Internet Search

Friend

Family

Professional/Medical Referral

Other

How soon are you hoping to start? *

As soon as possible

In the next 30 days

30+ days

Other

Do you have any recent or current injuries or surgeries (within the last year) that might affect your movement currently or how comfortable you feel with exercising? *

No

Yes (see next question below)

Other (see next question below)

Have you done any type of Pilates before? *

Yes

No

If you have done Pilates before, choose the options that best describe your experience. *

Pilates Mat classes (group)

Pilates Reformer classes (group)

Pilates classes using various studio equipment (group)

Private Pilates sessions

Pilates Mat classes online via YouTube or subscription service

Pilates studio appartus classes online via YouTube or subscription service

I am Pilates trained or am a Pilates teacher

Other

If you have any Pilates specific apparatus, check all the boxes that apply. *

If you don't have any, check the last box that says, "I don't have any Pilates apparatus at home."

Reformer

Reformer/Tower

Springboard/Wall Springs Board

Tower

Wunda Chair/Pilates Chair/Stability Chair

Malibu Pilates/Pilates Pro Chair

Pilates (Upholstered) Mat

Arm Chair/Baby Chair

I don't have any Pilates apparatus at home

Do you feel ready to commit the time, money, & energy need for 6-12 months of consistent weekly Pilates sessions? *

Yes

No

Maybe

Other

Are you willing & able to do Pilates or Pilates-based exercise "homework" between your studio sessions? *

(Homework usually involves no props or easily purchases props).

Yes

No

Maybe