Postnatal Pre-Screening Form

Pre-screening form for Outdoor New Mums Bums and Tums and other postnatal exercise classes.

  • In case of emergency
  • Please tick if you have experienced any of the following during or after pregnancy:
  • e.g. hypermobility, back operation, prolapse, cancer, major surgery, IVF?
  • If so please give details
  • Antenatal Clients Only

  • Postnatal Clients Only

    Data Protection: The information you provided in this form will be used for my purposes only and will not be shared with any third party without your prior permission. It will be stored for 5 years on my private computer. Please confirm that you agree.
  • Please DO NOT attend class should you or a member of your household have, even minor symptoms akin with those related to the Coronavirus Covid-19 Please ensure yours and your toddlers hands are washed thoroughly prior to and after each class to help avoid spread of infection.