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Consents Signed?
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Pilates Consent
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Modifications/Contraindications
• • •
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Medical Necessity Determined?
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Pilates 30 Minute Session: Cash
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Pilates 45 Minute Session: Cash
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Pilates 60 Minute Session: Cash
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Pilates: Auto Injury / Insurance Client
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Referred By Doctor/Healthcare Provider
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Pilates
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Pilates
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Pre-Pilates/Therapy
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Pre-Pilates/Therapy
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Forward Head Bow
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Breath & Pumping Only (Hundreds Protocol)
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Single leg table top
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Double leg tabletop
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Pelvic Rocking
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Toe Taps from 90 Degrees
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Clockwork
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Rib Cage Arms
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Reformer, Level I
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Level I
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Footwork
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Tendon Stretch
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Hundreds
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Reach & Pull
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Arm Circles
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Tricep Press
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Leg Circles/Frog
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Short Spine Massage
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Stomach Massage, Hands Back
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Stomach Massage, Round:
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Stomach Massage, Reaching
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Twist
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Long Box Series, Pulling Straps I
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Long Box Series, Pulling Straps II
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Short Box, Round
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Short Box, Flat
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Short Box, Side to Side
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Short Box, Twist
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Short Box, Tree
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Short Box, Side Sit-Ups
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Long Stretch
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Long Stretch Elephant
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Long Stretch, Stork
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Knee Stretches
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Knee Stretch Series, Round
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Knee Stretch Series, Arched/Flat Back
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Knee Stretch Series, Knees Off
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Running
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Pelvic Lift
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Front Splits
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Forward Lunge
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Side Kneeling Arm Series
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Seated Chest Expansion in Box
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Standing Balance Work with Magic Circle
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Roll Down to Cat Cow on Box
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Seated Roll Down Series
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Seated Roll Down w/ Lever Arms
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Seated Roll Down w/ Rotation
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Reformer, Level II
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Level II
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Rowing Series, Shave The Head
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Rowing Series, Hug A Tree
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Long Box, Hamstring Curls
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Long Box, Swan - Prep
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Long Box, Back Stroke
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Long Box Teaser
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Long Stretch, Down Stretch
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Long Stretch, Up Stretch
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Long Stretch, Arabesque II
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Short Spine Massage, Tendon Stretch:
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Short Spine Massage, Semi Circle:
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Short Spine Massage, Chest Expansion
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Short Spine Massage, Thigh Stretch, No Arch
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Short Spine Massage, Corkscrew
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Side Splits
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Front Splits, Hands Off
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Reformer, Level III
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Level III
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Overhead
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Rowing Series, Into Sternum (1)
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Rowing Series, 90 Degress (2)
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Rowing Series, From the Chest (3)
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Rowing Series, From The Hips (4)
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Short Box, Tree - Front and Side
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Long Stretch, Arabesque I and II
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Long Stretch, Back Stretch
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Thigh Stretch
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Kneeling Arm Series, Up and Down, Arm Circles
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Twist
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Snake
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Long Spine Massage
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Balance Control Front
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Balance Control Back
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Russian Splits
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Assessment
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Response To Therapy
• • •
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Signs Of Continued Injury
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Treatment Plan
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Next Session Recommendations
• • •
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Additional Notes (Dictate)
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Recommendations
• • •
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General Instruction Comments
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