To sign up or find out more about our services, please fill in the form below and we will get back to you.
 

Name:

Phone Number:

E-Mail Address:

Your Location:

Date of Birth (dd/mm/yyyy):

Type of injury/medical condition:

If other give details:  

How long have you been injured/had this condition?

Which of these services would you be interested in?
 
Use of specialist rehabilitation equipment
Holistic therapy
Adapted painting classes
Adapted music classes
One on one personal trainer sessions

 
Have you used any specialist equipment in the past for example, fes bikes? If yes, please give details.
YesNo
 
Details: