This is the type of letter Jo would write to your health professional

Miss J E Southgate
(Jo's address)

Date..................... 

Dear 

Clients Name:
Clients address:
DOB:

Clients name, a former/current patient of yours, has shown interest in attending my Pilates class.  I am writing to ask you to sign and return the attached consent form if you feel that he is fit to join in.

I also enclose a signed disclosure form from Clients Name which gives you authority to send details of his condition through to me.

Clients Name is very keen to start Pilates to make his/her body stronger.  I am unable to take him/her as an insured participant until I have written evidence he/she is fit to join in therefore please would you return the consent form at your earliest convenience.

Thank you in advance.

Yours sincerely

Miss Jo Southgate

Pilates and Fitness Instructor
0795 867 9909   

Disclosure Form

I (Client Name).......................................... (DOB…………..) am signing below to certify I give permission for  to disclose any information about my physical condition to my Pilates Teacher 'Jo Southgate'.

Sign:………………………………………...              Date:………………………

…………………………………………………………………………………………

Consent Form

I’m signing this form to certify that (Client name).................................... (DOB………….) is fit to attend Pilates lessons/Private Pilates/SuperTone lessons with Jo Southgate.

Sign:………………………………………...              Date:………………………

Print:………………………………………...

Job title:……………………………………..

Company Name:………………………………………………………………………...

Tel:……………………………………………………………………………………...

Email:…………………………………………………………………………………...

Please return to:-

Miss Jo Southgate
(Jo's address)