Personal Practice Intake
In the below questions, take your time to explain goals you are looking to move towards and your current lifestyle so when we work together to build your practice, we truly understand where you are today. Meeting yourself where you are the important for this practice to be really what you need to connect to yourself; mind and body. The key is we will be building your practice TOGETHER! I am here to just listen and help guide/facilitate the work. This is a partnership to help you meet yourself and to grow your mobility and resiliency that we all deserve.
First Name *
Last Name *
Pronouns *
Email Address *
Describe a typical day for you. List any challenges you are facing (like getting down to the floor to pick your child or something up). *
List some of the things your body does that you are comfortable with. Example, my body is able to express my dance OR my body is able to walk me and take me places. What really are you feeling where you are today--what are you feeling good with?
List some movements or daily activities which you are finding challenging. For example, sit at a desk all day, on my feet all day for work, have children I need to lift and carry and it's getting harder as they get bigger. What really are you facing daily that makes you unhappy or may cause you some pain?
What activities do you currently do for yourself? This could be movement based, mind based or just a fun hobby. This could be meditation, dance, singing, play games with your partner/friend, baking, reading. Of these activities, highlight or indicate which truly bring you the most joy.
Is there anything specifically you want to attain? For example and not limited to: Are you looking to be able to bend over without pain? Do you wish you didn't grunt everytime you got up? I really want to do a handstand! The sky's the limit on this. And it can be more than one. If there are more than one, please try to list in your favourite/priority order.
Anything about you that you think I should know about? Do you have fears (falling, smacking your face, heights), pain or injuries (lower back pain, wrist pain) or personal impacts (going through breakup, Covid has really gotten to you, anxiety) which you are willing to share? These may help us to determine some other items to add to the practice.
How long and how often are you wanting to do this personalized practice? Be honest and realistic! I'd rather see you doing a 10 min practice 2 times a week if that's all you can afford. Again, meet yourself where you are.
FINALLY, any questions for you me that you'd like me to expand upon? Do you want to know about my training, my personal challenges or anything! Happy to share.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy