Student Intake

A movement & health history questionnaire to help me create a focused and satisfying session for you. Please feel free to contact me directly before your session if there's anything else you'd like to share: Looking forward to working with you soon!
  • Health + Wellness History

  • If you answered yes to any of the previous questions, please specify below (ie. spinal injuries, arthritis, osteoporosis etc. along with location, date diagnosed and so forth).
  • Lifestyle + Movement History

  • Please describe what physical activities you typically engage in and how often. Also, let me know what types of exercise/movement you LOVE most.
  • What kinds of movement have you done? Include sports, hobbies, movement or physicality related to work and play. What would you LOVE to be able to do again?
  • Please share at least 1 short-term goal (to achieve in the next 1-3 months) and 1 long-term goal (to achieve in the next 6-12 months).
  • Consider areas of the body you'd like to explore/learn more about; exercises you'd like to explore; pain, limitations, or injuries you'd like to troubleshoot.