Get Started Name * First Name Last Name Email * Birthday * MM DD YYYY Health Objectives * Medical History * surgeries, medications, etc Injuries/pain * Equipment Availability Please list equipment you will have available for workouts Exercise History Sleep * Best time of day to meet with me 5am-8am 8am-12pm 12pm-4pm 4pm-8pm What time zone do you live in? Average stress levels over the past 6 months * 1 (low) 2 3 (moderate) 4 5 (high) I feel connected to my higher purpose in life Yes No Not sure I would describe my life as peaceful Yes No Somewhat I have a strong support system Yes No Somewhat I have a daily gratitude and/or meditation practice Yes No How important do I consider my own wellbeing? 1 (not very important) 2 3 (somewhat important) 4 5 (very important) Cancellation Policy I understand that if I cancel any appointment within 24 hours of the scheduled appointment I will be charged the full price of said appointment and will not be issued a refund or a rescheduled session. Agree Disagree Extra Thank you for your responses! I will do my best to reach out within 48 hours. If you are looking for more information, book a consultation or email me. Email Me
