New Virtual Client Questionnaire
Let me get to know you! We'll make sure we're on the same page and I can understand how best to help you :)
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
What brings you to me? What do you want to work on?
Are you open to spending money on simple equipment to have at home to perform certain techniques? ($100 or less)
Yes
No
What is a realistic time commitment that you can put towards an at-home program?
Daily
4-5 times a week
2-3 times a week
Weekly
What is a realistic amount of time can you put towards each routine?
20 min or less
30-40 min
Whatever amount gets rid of my pain
Can you commit to putting in a few weeks (or months) of consistent routine implementation?
Yes
No
What best fits what you're looking for?
A customized routine emailed to me that I will do on my own
A customized routine, a check-in Zoom call with Julia at the beginning to ensure my form is right, and one follow up call a month later
A customized routine with weekly check-ins/unlimited adjustments to programs made with Julia
Submit
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