I’m looking forward to meeting you!

I value your time, so please answer these questions so I can understand how I can best help you. All questions are required to be answered.

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Email *
Full Name *
Phone number *
What is your dream goal for working with me? *
Why is that important to you? *
How long have you had back pain? *
In the last 7 days, on a scale of 1-10, what is the worst your back pain has been? *
Minimal, activities not impacted
Excruciating, can't get out of bed
In the last 7 days, on a scale of 1-10, what is the average back pain you've had? *
Minimal, activities not impacted
Excruciating, can't get out of bed
On a scale of 1-10, how much are you able to do your normal activities? *
No problems, able to do what I want with no restrictions
Difficulty functioning, struggling to even get out of bed
Do you think you can do this on your own? *
Do you want to sustain your result after you achieve it? *
You already know it’s not easy to achieve your goal. Will you take my recommendations and do what I ask in order to help you reach your goal?
 *
Are you able to workout twice per week? *
Why are you applying now? *
Why do you think you'll succeed with this program? *
My average client reduces their back pain by 60% or more in the first 6 weeks. Are you ok with that?
 *
Have you struggled with maintaining self-directed exercise in the past? *
Do you think you'll be more successful with an expert helping you along the way? *
Do you think you'll be more successful with daily accountability? *
Is it more important that you get rid of your pain quickly or that it’s permanent?
 *
What is your timeline for getting started? *
If the program helps you overcome your back pain and helps you build strength safely, will you be willing to commit to workout with me 2x per week? *
If the program helps you overcome your back pain and helps you build strength safely, do you have access to cash and/or credit to invest in yourself? *
Is there anything else you want to share with me?
Do you want to arrange a time to chat? *
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