Bespoke Postnatal PT Questionnaire

Postnatal Pre-Activity Health Questionnaire

Please answer all questions then click Send at the bottom of the form. Your completed form will be emailed directly to me and will be treated in full confidence. You will receive an email of your completed form acknowledging its receipt.

At your 6-8 week check-up did you receive medical clearance to exercise? 

Epidural

Recently fitted IUD?

Have you suffered from any of the following? Please tick all that apply and provide details in the box below.