New Client Information

Name *

First Name

Last Name

Contact Number *

(###)

###

####

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender Identification

She/Her

He/Him

They/Them

Prefer Not To Say

Emergency Contact Person *

First Name

Last Name

Emergency Contact Number *

(###)

###

####

How did you hear about Studio Evolve? *

Check all that apply if more than one.

I live in the neighborhood

I work in the neighborhood

Referral from a friend/family member

Referral from a health care professional

Internet Search

Social Media

I am a returning client

Referral from SE staff

Other

I understand that 24 HOURS ADVANCE NOTICE IS REQUIRED for all cancellations. There is no charge for cancellations received with more than 24 hours notice. For cancels with less than 24 hours, full session rates apply. Your time is reserved for you. *

I agree to this policy.

ALL PACKAGES ARE NON-REFUNDABLE AND NON-TRANSFERABLE. Membership packages have different expiration dates. For more flexibility, Standard Packages expire 3 months from date of purchase. Please purchase the best package for your schedule and circumstance. *

I agree to this policy.

What kinds of other movement practices have you enjoyed (either recently or in the past)?

Check all that apply.

Pilates Mat

In Studio/Equipment Pilates

Gyrotonic or Gyrokinesis

Yoga

Walking/Hiking

Running

Cross Fit

Competitive athletics

Other

What are your biggest fears or hesitations around starting Pilates/fitness sessions?

Please check all that apply.

Getting injured

Feeling old

Unable to play with kids/grandkids easily

Missing out on activities with friends/family

I won't be able to do my job due to physical pain

I have no fears or hesitations!

Other

I am primarily interested in: (please check all that apply)

Pilates

Gyrotonic

Bodywork

Private Sessions

Small Group Classes

Workshops

Whatever will get me to my goals!