PRIVATE CONSULTATION REQUEST FORM

First name

Last Name

Phone Number

Specify any health concerns we should be aware of:

List any current/past injuries that may impact your session:

Describe your activity level:

Specify your preferred day and time for the initial session:

Please indicate your interest: Required

Private Pilates

Private Personal Training

Vai Signature Bodywork

If you selected Private Pilates or Personal Training please select one of the following:

Transition into classes

Continue with private lessons

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