Aqua natal health questionnaire


We are so glad you have chosen to attend our aqua natal class, however first we just need to make sure that you are safe & ready to exercise.

Please fill in the form below to the best of your knowledge. If you have any concerns about your health or participating in exercise please contact your GP/ Midwife.  All details are kept CONFIDENTIAL.

Name *
We require your contact number in case we need to contact you about class changes or in the unlikely event of a cancellation.
No. baby *
GP/Midwife clearance to exercise *
Do you have any concerns related to your health that you feel may impact on your ability to exercise during your pregnancy? If the answer is yes please contact your main care provider to obtain clearance if you have not already done so. We may ask you to provide a letter before attending our class.
Level of activity prior to falling pregnant *
Have you experienced any of the following *
Please tick if so (please note not all of these conditions will prevent you from exercising with us, we just like to know so we can adapt the class for you if necessary)
Name and contact number
WomenFIT Agreement *
I confirm that the information I have given is correct and to the best of my knowledge. I am aware that I must feel able to exercise prior to the class and I will notify the WomenFIT instructor if I feel unwell at any time during the class. Whilst I am aware that every effort has been taken to ensure the class is suitable for prenatal women, I understand and agree that my participation and safety is my own responsibility within a WomenFIT class.
I have read and understood the terms and conditions of Aqua natal by WomenFIT *