Holistic Movement Coaching 1 on 1
Application to work with me on your movement journey
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Briefly write what motivated you to seek out one on one coaching.
Which of these topics would you be interested in covering with your 1:1 coaching?
Pain Neuroscience
Mobility
Strength Training
Sleep
Stress Management
Meditation/ Mindset
Other
If you listed "other" as an answer, write here what other topics might interest you if we worked together 1 on 1.
What are you currently doing as part of a regular movement routine? (Don't forget - walking counts!)
What factors are currently limiting you from a regular movement practice?
I don't know where to start
I don't know what I should and shouldn't be doing
I'm afraid of getting injured
I'm not sure how to deal with my pain or prior injuries
I don't know how to find the time to be consistent
I'm not motivated/ I need accountability
What is your biggest barrier right now in your movement journey? (Feel free to pick one from the previous question or write in your own).
What form of movement do you typically enjoy the most? (This can be walking, strength training, stretching, hiking, biking, gardening, etc)
What are your primary goals/ what do you want to get out of coaching?
Decrease and self manage my pain
Get stronger
Move more easily
Gain endurance
Improve tension & stress
Be able to do more activities
Other
Free write any other goals you are interested in pursuing (PS it's ok if you are not sure what you want yet, I can help you figure that out!)
Is there anything else you want me to know before we connect and determine your individualized path to holistic movement? (FYI - there will be a separate intake form with your health/ medical history prior to your first session, so you can skip that stuff, unless you would like to discuss further prior to starting)
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