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Questionnaire 

(Your information will remain confidential.)

Do you currently exercise or do mindful movement ie. Pilates, Nia, Yoga? Required
Have you practiced Pilates before? Required
Have you experienced Nia? Required
Have you experienced F.U.N. Strength? Required

MEDICAL, INJURY & HEALTH HISTORY 

Tick anything that applies - past or present
Which words best describe how your body feels most days? Required
Do you experience pain, tenstion or discomfort with movement? Required
Sleep quality: Required
Do you spend most of your day seated or at a computer? Required
Do you feel you have sufficient time for recovery between work, life, and movement? Required
Pleas read and acknowledge with a tick: Required
Participant agreement, waiver & consent: Required

Section 2:

“Each day can be different in our bodies. Lets remain curious on this journey of self discovery, healing and listening.” Jeanne

BODY COMPASS Questionnaire 

(Your information will remain confidential.)

Do you currently exercise or do mindful movement ie. Pilates, Nia, Yoga? Required
Have you practiced Pilates before? Required
Have you experienced Nia? Required
Have you experienced F.U.N. Strength? Required

MEDICAL, INJURY & HEALTH HISTORY 

Tick anything that applies - past or present
Which words best describe how your body feels most days? Required
Do you experience pain, tenstion or discomfort with movement? Required
Sleep quality: Required
Do you spend most of your day seated or at a computer? Required
Do you feel you have sufficient time for recovery between work, life, and movement? Required
Pleas read and acknowledge with a tick: Required
Participant agreement, waiver & consent: Required

“Each day can be different in our bodies. Lets remain curious on this journey of self discovery, healing and listening.” Jeanne

Thanks for submitting!

If you would like to print out the client form please click here to download the new Client Questionnaire

Thanks for submitting!

If you would like to print out the client form please click here to download the new Client Questionnaire

Questionnaire 

(Your information will remain confidential.)

Do you currently exercise or do mindful movement ie. Pilates, Nia, Yoga? Required
Have you practiced Pilates before? Required
Have you experienced Nia? Required
Have you experienced F.U.N. Strength? Required

MEDICAL, INJURY & HEALTH HISTORY 

Tick anything that applies - past or present
Which words best describe how your body feels most days? Required
Do you experience pain, tenstion or discomfort with movement? Required
Sleep quality: Required
Do you spend most of your day seated or at a computer? Required
Do you feel you have sufficient time for recovery between work, life, and movement? Required
Pleas read and acknowledge with a tick: Required
Participant agreement, waiver & consent: Required

Section 2:

“Each day can be different in our bodies. Lets remain curious on this journey of self discovery, healing and listening.” Jeanne

BODY COMPASS Questionnaire 

(Your information will remain confidential.)

What activities feel most challenging for your body right now? Required
How would you like to feel in your body?) Required
Have you experienced F.U.N. Strength? Required

MEDICAL, INJURY & HEALTH HISTORY 

Tick anything that applies - past or present
Energy, Sleep & Digestion. How would you describe your sleep most nights? Required
How does your energy tend to feel during the day? Required
Do you experience any digestive concerns? Required
Does tightness return quickly after stretching or releasing? Required
Which areas feel hardest to let go of? Required
Nervous System & Stress Load How familiar are you with the nervous system and its impact on wellbeing? Required
How often do you notice you’re in stress mode (fight/flight/freeze)? Required
How does stress tend to show up in your body? Required
What helps you feel more regulated or settled? Required
Patterns & Tendencies. When something feels difficult, what do you usually do first? Required

“Each day can be different in our bodies. Lets remain curious on this journey of self discovery, healing and listening.” Jeanne

Thanks for submitting!

Thanks for submitting!

If you would like to print out the client form please click here to download the new Client Questionnaire

Questionnaire 

(Your information will remain confidential.)

Do you currently exercise or do mindful movement ie. Pilates, Nia, Yoga? Required
Have you practiced Pilates before? Required
Have you experienced Nia? Required
Have you experienced F.U.N. Strength? Required

MEDICAL, INJURY & HEALTH HISTORY 

Tick anything that applies - past or present
Which words best describe how your body feels most days? Required
Do you experience pain, tenstion or discomfort with movement? Required
Sleep quality: Required
Do you spend most of your day seated or at a computer? Required
Do you feel you have sufficient time for recovery between work, life, and movement? Required
Pleas read and acknowledge with a tick: Required
Participant agreement, waiver & consent: Required

Section 2:

“Each day can be different in our bodies. Lets remain curious on this journey of self discovery, healing and listening.” Jeanne

BODY COMPASS Questionnaire 

(Your information will remain confidential.)

Do you currently exercise or do mindful movement ie. Pilates, Nia, Yoga? Required
What activities feel most challenging for your body right now? Required
How would you like to feel in your body?) Required
Have you experienced F.U.N. Strength? Required

MEDICAL, INJURY & HEALTH HISTORY 

Tick anything that applies - past or present
Energy, Sleep & Digestion. How would you describe your sleep most nights? Required
How does your energy tend to feel during the day? Required
Do you experience any digestive concerns? Required
Does tightness return quickly after stretching or releasing? Required
Which areas feel hardest to let go of? Required
Nervous System & Stress Load How familiar are you with the nervous system and its impact on wellbeing? Required
How often do you notice you’re in stress mode (fight/flight/freeze)? Required
How does stress tend to show up in your body? Required
What helps you feel more regulated or settled? Required
Pleas read and acknowledge with a tick: Required
Participant agreement, waiver & consent: Required

“Each day can be different in our bodies. Lets remain curious on this journey of self discovery, healing and listening.” Jeanne

Thanks for submitting!

Thanks for submitting!

If you would like to print out the client form please click here to download the new Client Questionnaire

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