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1-on-1 Coaching Application
Full Name
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Email Address
*
Preferred Method of Contact
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Preferred Method of Contact
A
Phone
B
WhatsApp
Phone Number
WhatsApp Number
What pain are you experiencing, and where is it showing up in your body?
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How long have you been going through this?
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When do you struggle/have pain the most?
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On a scale of 1–10, how much is this issue affecting your ability to enjoy training or daily life?
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On a scale of 1–10, how much is this issue affecting your ability to enjoy training or daily life?
0
1
2
3
4
5
6
7
8
9
10
What have you already done to try and fix this? (PT, massage, rest, other programs)?
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Which side experiences issues?
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Which side experiences issues?
A
Left
B
Right
C
Both
Are you currently lifting? If so, what movements cause the most irritation?
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Before we go further — does any of this apply to you?
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Before we go further — does any of this apply to you?
Recent trauma, fall, or accident connected to this
Unexplained swelling, fever, or weight loss alongside the pain
Numbness, tingling, or weakness that doesn't go away
A doctor has told you that you need surgery or further medical workup
None of these apply
If any of these apply, please understand that this falls outside of what I can help and coach you with. I highly recommend for you to go and seek professional Help.
Fixing these patterned issues requires 15–20 minutes of daily corrective work outside your regular training. Can you commit to that for the next 4 weeks?
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Fixing these patterned issues requires 15–20 minutes of daily corrective work outside your regular training. Can you commit to that for the next 4 weeks?
A
Yes
B
No
You may need to reduce or pause training completely in the affected area for a period while we correct the root pattern. Are you ready for that?
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You may need to reduce or pause training completely in the affected area for a period while we correct the root pattern. Are you ready for that?
A
Yes
B
No
Imagine it's 90 days from now and this issue is gone. What does that look like? How does that change your training, your daily life, and how you feel?
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What's your monthly budget for solving this?
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What's your monthly budget for solving this?
A
Under $500
B
$550-$700
C
$750-$1,000
D
$1,000+
I understand that this coaching is for educational and corrective exercise purposes. I am not a doctor or physical therapist.
*
I understand that this coaching is for educational and corrective exercise purposes. I am not a doctor or physical therapist.
I have read, understood, and agree to the terms above.
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