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On-Demand Video/ Virtual Pilates Class Informed Medical Consent

Review the medical consent form below, and confirm your agreement through clicking on the button below.

Introduction: 

Breath in Motions Pilates, LLC (“BMP”), is offering on-demand Pilates videos and virtual classes in lieu of in-person appointments. These sessions are designed to allow clients to continue their Pilates-based movement practices with BMP movement specialist from the comfort and privacy of their own homes.

 

Benefits:
  • Continuation of general strengthening, mobility and stability work

  • Continuation of Pilates education, including strengthening, mobility and stability work

  • Enhancement of both physical and psychological benefits of movement and breathing 

Possible Risks:

As with any in-person therapy or Pilates appointment, there are potential risks associated with unsupervised on-demand videos or virtual Pilates classes. These risks include, but may not be limited to:

  • Limitations with BMP movement specialist’s ability to personalize a client's unique, individual workout based on physical capabilities or acute/chronic injuries and/or pain 

  • Limitations with BMP movement specialist’s ability to see any physical abnormalities or errors in positioning or movement that could result in physical harm 

  • Possible connection issues with technology that could limit visibility or auditory capabilities between client and BMP pre-recorded videos or Zoom class connections

  • Environmental and equipment hazards and failures resulting from the patient's home and personal equipment

 

By participating in either on-demand videos or virtual classes, I represent that I understand, acknowledge, and/or agree to the following: 
  1. I understand it is my responsibility to choose videos that are most appropriate for my body based on the specific level system and descriptions of each on-demand video

  2. I understand it is my responsibility to follow modifications given by teacher or opt out of an exercise if it causes me pain, feels unsafe or I am physically incapable of performing the movement

  3. I understand it is my responsibility to discontinue any and all on-demand videos or classes if I experience, including but not limited to, increased physical pain, recurring physical pain, acute injury before, after or during on-demand class, or if told by a separate healthcare professional to discontinue 

  4. I understand it is my responsibility to discontinue on-demand or virtual classes and attend supervised Pilates classes if I have a history of chronic injuries, multiple surgeries, a need for support and increased safety with the use of Pilates equipment, or anything else that would keep me from performing on-demand mat classes safely 

  5. I understand if BMP uses a piece of equipment in the on-demand videos or virtual mat classes that it is my responsibility to ensure my own equipment is not faulty and used according to the cues given by BMP

  6. I understand that I am responsible for providing a safe and secure location for all on-demand and virtual classes. I further understand and acknowledge that BMP cannot ensure my safety in my own home. I agree that BMP has made no representations as to the safety or fitness of my home or chosen location for on-demand or virtual classes. 

  7. If I have been working with any type of physician, I have obtained clearance to perform on-demand Pilates sessions and/or virtual Pilates classes, and am confident in my ability to stay safe, and understand any physical limitations. 

By participating in BMP on-demand Pilates videos and/or virtual classes, I acknowledge that I have read, understand, and agree to the terms and information provided above. With this participation I agree to indemnify and forever hold harmless BMP, LLC for any and all damages of any kind that may result from participating in these on-demand videos. 

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