Par-Q Form – Georgina Kay

Par-Q Form

Please complete this form before taking part in any of my live classes. If you have already filled this form in, you don’t need to fill in again unless anything has changed.

Health screening

If you answered yes to one or more questions

You should talk to your doctor by phone or in person before you start becoming more physically active. Tell your doctor about the questionnaire and which questions you answered YES to. Please also tell your instructor, if you have already got medical clearance for Yoga/Pilates or moderate exercise in general, please fill in the declaration below. If your health changes so that you answer YES to any of the above, please inform your teacher. By submitting this booking form, you have asked to receive emails and communications from us. This will keep you informed on updates. You can unsubscribe at any time. This is following General Data Protection Regulations (GDPR) 25th May 2018. By signing & submitting this booking form you confirm you have read and understood this questionnaire. If you have any concerns, contact us by email and ensure you speak with your instructor at the start of your class.


This applies if you have answered yes or no to any of the above questions. I declare I have been cleared by my doctor (GP, specialist or other qualified health professional) to take part in moderate exercise. Please submit this form to indicate your informed consent.