Wellness Plan Stretch & Roll

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1. Where did you hear about the class?

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2. How would you like to pay for the class?

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3. Would you like to pay per session or would you like to book a block of sessions?

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4. If you would like to book a block of sessions, please choose how many sessions you would like.

You can take your 6/10/16 sessions at any time during the year & you can renew your block of sessions or choose a different block when your sessions finish.

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5. You have a choice of classes. Please choose the class session you would like to do.

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6. Please give an indication of your age

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7. Why would you like to do the class? What is your goal? What would you like to achieve?

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8. Do you have any medical conditions? Do you have PTSD? Difficulties with fibromyalgia, anxiety, panic attacks, lack of confidence, self esteem, or is there anything else you would like to say about here? All information given is completely confidential. The classes have been designed to be fibromyalgia friendly and for PTSD and the other issues mentioned above. There may be some medical conditions that might mean the class or some of the movements would need to be adapted, or may not be suitable. Please give as much information as you can, as this will enable me to create your session for you.

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9. Some of the ladies who do the classes/sessions are vulnerable women. Or who have certain difficulties/issues. They therefore prefer to keep their class sessions as private sessions. There are other ladies however who do the sessions for general fitness, mobility and for strength and conditioning, or as part of their exercise schedule. Would you be willing for your sessions to be shared, for some photos to be taken of you in the class and for a review to be given by you?

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10. The Wellness Plans are created to work around you and with your lifestyle. Are you just looking for exercise classes or are you interested in other parts of exercise, fitness and wellbeing?

Check out our survey templates or create your own.