Back to the Body 1-1 Program Intake form 

Thank you for your interest in the Back to the Body 1:1 Journey — a 3 month journey designed to help you come home to yourself and your body. 

This embodiment coaching journey for women who want to reconnect with their body, emotions, and inner sense of self.

This work supports emotional awareness, nervous system regulation, and self-trust through somatic practices, movement-based exploration, and embodied reflection.

Together we explore your relationship with your body, the patterns that create disconnection, and practices that help you feel more grounded, present, and connected in your daily life.

This is a supportive, non-clinical coaching space. 

Full program description here https://www.lizdiaz.ca/backtothebody/

Please take a few minutes to reflect and answer the questions below with honesty and openness. Your responses will help me understand your intentions, needs, and whether this program is the right fit for you at this moment.  Please be sure to save my email in your contacts liz@lizdiaz.ca 

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First & Last Name 
Phone number 
Where are you located? (city and country)
How did you hear about this program
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