LOW PRESSURE FITNESS™ FORM

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What do you want to achieve in terms of your health and wellness?

Please also tell us your current concerns

What are your goals with learning LPF?

Do you have any medical conditions you'd like your instructor to be aware of?

The following is a list of possible contraindications for the practice of LPF, specifically the apena (breath hold). Please check any that apply to you and discuss with your practitioner.

Hypertension (uncontrolled)

Fever

Abdominal surgery within the last 3 months

Pregnant

Heart diseases (cardiopathy)

Glaucoma

Acute pain or inflammation

Pessary

IUD - wait 2-3 weeks after insertion

Any medical contraindication to exercise.

Abdominal surgery >3 months

Vaginal Delivery >6 weeks

Option 13

Option 14

Other

Any questions or concerns?

Contact Lisa:

Email: lisa@renewellnessmt.com

Phone: 406-600-7267

1200 Sawmill Rd

Philipsburg, MT 59858

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