New Client

Welcome
Please fill out prior to your session

First name

Last name

Email

Phone

Address

Yes, subscribe me to get reminders and emails

What are your goals in your wellness journey?

List any prior movement any bodywork history (Dance, yoga, weight lifting, etc.)

I am pregnant

Yes

No

Postpartum

Do you have any orthopedic problems that would limit or prevent you from exercising or receiving bodywork? (Specify which area and if it is the left or right side.)

List any prior surgeries or injuries and estimated dates: (C-section, frozen shoulder, plantar, carpal tunnel)

I Have Read and Agree to the Office Policies, Pilates Waiver.

https://www.lanajunehealth.com/office-policies

All appointments made are liable for a charge for no-shows and late cancellations after 24 hours. Lana June Health does not refund any purchases.

I understand there is a strict 24-hour cancellation policy. This is not only for the studio, and Lana but for the courtesy of the of the other clients.

New Client

Welcome Please fill out prior to your session

Welcome
Please fill out prior to your session