Postnatal Screening Form

The information collected in this form will be used only for the purpose of designing an appropriate fitness program for you and will not be disclosed to any third party without your consent.

We reserve the right to request a doctor’s clearance before allowing you to receive personal training with Kate Campbell Fitness.

Please fill out the form as thoroughly as possible.

Name *
Name
Address *
Address
Delivery date *
Delivery date
Type of delivery
Feeding
Pain
Do any of the following apply to you
Tick the type of exercise you did regularly prior to becoming pregnant
How did you hear about Keep Mums Fit?
Informed consent