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Postpartum Core Course

How did you hear about this group coaching opportunity?

How did you hear about this group coaching opportunity?

What are you hoping to learn from this program?

What is your current level of exercise?

What is your current level of exercise?

Are you currently nursing?

Are you currently nursing?

Describe how many times you gave birth, the type of deliveries you experienced, your postpartum recoveries, and any kind of complications you had (if any) in regards to your delivery and recovery.

Have you/were you ever diagnosed with diastasis recti?

Have you/were you ever diagnosed with diastasis recti?

Have you ever been diagnosed with pelvic floor dysfunction?

Have you ever been diagnosed with pelvic floor dysfunction?

Have you ever been diagnosed with prolapse?

Have you ever been diagnosed with prolapse?

Have you ever been referred to a physical therapist specifically to help with pelvic floor and core stability or prolapse?

Have you ever been referred to a physical therapist specifically to help with pelvic floor and core stability or prolapse?

Has your doctor ever said that you have a heart condition and should only do physical activity recommended by a doctor?

Has your doctor ever said that you have a heart condition and should only do physical activity recommended by a doctor?

Do you feel pain in your chest when you do physical activity?

Do you feel pain in your chest when you do physical activity?

In the past month have you had chest pain when NOT doing physical activity?

In the past month have you had chest pain when NOT doing physical activity?

Do you lose your balance because of dizziness or ever lose consciousness?

Do you lose your balance because of dizziness or ever lose consciousness?

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Is your doctor currently prescribing you drugs for your blood pressure or a heart condition?

Is your doctor currently prescribing you drugs for your blood pressure or a heart condition?

Do you know of any other reason why you should not participate in physical activity?

Do you know of any other reason why you should not participate in physical activity?

Mental/Emotional Survey

Which of these describes your attitude about exercise today?

Which of these describes your attitude about exercise today?

How many times have you attempted to “get back in shape” after giving birth?

For you, what is the most difficult part of keeping and adhering to an exercise routine?

Which of these describes your attitude towards nutrition today?

Which of these describes your attitude towards nutrition today?