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WHERE IS YOUR BODY AT ?

To help me to better support you, please fill out the questions. Related to your individual physical body and its foundation.

 

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Question 1 of 19

1:What Age range do you fall under?

A

Age 14-17

B

Age 18-21

C

Age 22-30

D

Age 30-35

E

Age 35-42

F

Age 43-47

G

Age 48-52

H

Age 53-57

I

Age 58-67

J

Above the Age of 68 Yrs of Age

Question 2 of 19

2:Do you workout? 

A

yes

B

no

Question 3 of 19

3:Have you had a c-section?

A

Yes

B

No

Question 4 of 19

4:Have you had any injury/sprain to any of the body areas? (Choose multiple is they apply)

(Select all that apply)
A

A:Neck

B

B:Arms

C

C:Hands

D

D:Fingers

E

E:Elbows

F

F:Shoulders

G

G:Spine

H

H:Hips

I

I:Knees

J

J:Ankles

K

K:Toes

L

L:Back

M

No sprain or Injury to any areas

Question 5 of 19

5:Select where you have had surgery on your body. (Choose multiple is they apply)

(Select all that apply)
A

A1:Brain

B

A2:Face

C

A3:Eyes

D

A4:Throat

E

A5:Shoulders

F

A6:Arms

G

A7:Hands

H

A8:Elbow

I

A9:Fingers

J

A10:Hip

K

A11:Spine

L

A12:Knee

M

A13:Ankle

N

A14:Feet

O

A15:Toes

P

A16:Leg

Q

No surgery

Question 6 of 19

6:Is your goal to avoid pain?

A

yes

B

no

Question 7 of 19

7:Is your goal to lose weight?

(Select all that apply)
A

yes

B

No

Question 8 of 19

8:Is your goal to build muscle and tone?

A

yes

B

no

Question 9 of 19

9:Is your goal to gain mobility?

A

Yes

B

no

Question 10 of 19

10:Hormonally are you more female or male? This is important from a genetic factor. Your answer is helpful so I can help you.

(Select all that apply)
A

female

B

male

Question 11 of 19

11:Is your goal to learn how to train more efficiently and effectively. Learning how to activate muscles with proper form and posture? Saving time and adding conscious training into your workouts?

A

yes

B

no

Question 12 of 19

12:Are you interested in doing a 1 on 1 consultation assessment or discovery group call related to how your train on the gym floor? 

A

1 on 1 Consultation Assessment

B

Discovery Group Call/Webinar

C

Not interested at all

D

maybe later

Question 13 of 19

13:Have you done any Fertility treatments in the past?

A

YES

B

NO

Question 14 of 19

14:Do you have a monthly period every month?

A

Yes

B

No

Question 15 of 19

15:Do you take any contraceptives to prevent pregnancy?

A

YES

B

NO

Question 16 of 19

16:Do you have irregular periods? You are unsure when it comes.

A

YES

B

NO

Question 17 of 19

17:Are you in menopause?

A

Yes

B

No

C

Surgical Menopause

Question 18 of 19

18:Do you take any hormone replacement therapy currently right now?

A

YES

B

NO

Question 19 of 19

19:What best suits you currently right now in your life phase?

A

1:Post partum Phase

B

2:My kids are older, they can take care of themselves

C

3:Pregnant Phase

D

4:career phase

E

5:Not sure what I am doing with my life phase?

F

6:Going through the motions of life, nothing motivates me

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