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Get in Touch

We would love to hear from you.

If you are struggling with any part of your health, or simply want to feel better in your body then fill out the Contact Form above.

 

If you have booked a consultation or Pilates 1-1 I encourage you to fill out the Balancore Health & Wellness Questionnaire below.

 

You can also schedule a call to discuss personalised nutrition consultations, our online Programmes or local Pilates classes. 

Balancore Health & Wellness Questionnaire

This form should take up to 15 minutes to fill out. There is no obligation to answer all questions, so if you are not comfortable sharing any of the information requested please leave the section blank. The information you share here is only accessible to your Balancore care provider.

Birthday
Day
Month
Year

About your health

Have you had surgery or given birth in the past 12 months?
Yes
No
Have you been advised by a health professional to currently restrict or be careful with exercise?
Yes
No
Have you any current pain or restrictions in movement?
Yes
No
Have you recently experienced any change in weight, energy or appetite?
Yes
No
Musculoskeletal concerns
Respiratory
Neurological
Cardiovascular
Endocrine
Digestion
Kidney
Liver
Female Hormones
Skin/Hair/Nails
Immune function
Mental wellbeing
Other Medical Conditions

Your Diet

Do you follow a particular dietary approach?

Testing

Please upload any bloods or labs you've had done in the past 6 months.

MEDICAL DECLARATION: I understand that I may be asked to seek advice or clearance from an appropriate healthcare professional before participating in certain activities or receiving particular recommendations.

Additionally, I confirm that the information provided is accurate and complete to the best of my knowledge. I agree to inform my practitioner of any change to my the information here that may affect my participation in any Balancore services.

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Thank you for filling out this questionnaire. I look forward to being able to help you in your journey towards better health.

Contact us
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