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.
Format: (000) 000-0000.
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
Should be Empty: