NEW CLIENT COVID-19 ONLINE INITIAL CONSULTATION
Full Name
Briefly describe the issue (eg. Painful left elbow)
When did it start?
What motivates you to take action now?
How does it affect your daily life?
What makes it worse?
What makes it better?
What is this issue it stopping you from doing?
What do you NEED to be able to do on a day to day basis that you cannot now?
If I can wave a magic wand what do you WANT to be able to do that you cannot do now?
When that pain happens, what thoughts come to your mind?
Any changes in energy or mood?
How would you like to feel that this issue is not allowing you to feel?
What is the longest pain/injury you ever had?
And the most painful injury you ever had
Finish this sentence "I've never been quite the same since...
Have you suffered from any emotional traumas (affect body behaviour)?
Are you exposed to any prolonged stress?
How is your sleep
1 10 How much of a priority is this in your life? How motivated are you?
1 10 In your gut, do you truly believe you can be free of pain again?
For this week, what will progress look like to you after 1 session?
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