Pre-natal 1:1 Personal Training

Firstly, huge congratulations on your pregnancy, and THANK YOU for welcoming me in to the beginning of your journey as a mama, it’s such a gift to be able to help you at such a pivotal stage.

Before we get started, there is a bit of paperwork to cover off!

Every client must fill in this Pre-natal Physical Activity Readiness Questionnaire, it’s an opportunity for me to understand a little more about your activity levels pre-pregnancy, medical history and how the pregnancy is currently going This information helps me to tailor a session personalised for you and where you’re at right now ensuring you move safely and confidently as your body grows a tiny human.

Please fill out this form as soon as possible, at the final step, there are details on how to pay a small deposit to secure our first session.

All information is 100% confidential and will not be disclosed or shared with anyone else. If you have any questions about this form, then please drop me an email at hello@coachingwitholivia.com.

About you

DD/MM/YYYY format
From week to week, I'll contact you through WhatsApp about upcoming sessions or accountability check-ins, are you happy with this?
If you answer no, we can use SMS or email

Your health

Are you on any medication?
This information will be used when considering the exercises you complete in class or if there is a medical emergency of any kind
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
Do you lose balance because of dizziness or do you ever lose consciousness?
Do you have other children?

Pregnancy and medical history

Are there any conditions that you suffered with during pregnancy?
How has your sleep been throughout pregnancy?
No right or wrong answer here

Agreements

I'm a fully qualified Level 3 Personal Trainer and Pre/Post-Natal Specialist and I'm happy to share my certification at any point.

Please read the following:

Absolute contra-indications is a condition that serves as a reason not to take a part in exercise due to the harm that it could cause further harm:

1. Significant heart disease 2. Significant lung disease 3. Incompetent cervix 4. Multiple gestation at risk of premature labour 5. Persistent spotting/bleeding or Placenta Praevia 6. Premature labour 7. Ruptured membranes 8. Uncontrolled Type 1 Diabetes or Gestational Diabetes 9. Evidence of Intrauterine Growth Restriction 10. Pregnancy-induced Hypertension or Pre-Eclampsia 11. Uncontrolled epileptic fits / seizures

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