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Private Coaching Online Intake Form

Answer questions about your history and your goals to get set up with a MovMed Coach.

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Question 1 of 12

On a scale from 1-10, how resilient do you feel to daily stresses? (10 is most resilient)

1-3

4-6

7-10

Question 2 of 12

On a scale of 1-10, what are your average energy levels throughout the day? (10 is the most energy)

1-3

4-6

7-10

Question 3 of 12

On a scale of 1-10, how difficult is it for you to relax? (10 is most difficult)

1-3

4-6

7-10

Question 4 of 12

What are the current discomforts you deal with either mentally or physically?

Question 5 of 12

What events or injuries do you believe you still need to heal from?

Question 6 of 12

What activities do you want to perform better at, or want to return to doing?

Question 7 of 12

What treatments or remedies have you tried, and which have been the most effective?

Question 8 of 12

Have you ever worked with a personal trainer or movement coach before? If so, what did you enjoy our dislike about the experience?

Question 9 of 12

What are you hoping MovMed can help with?

Question 10 of 12

What days of the week, and times of the day are you looking for coaching? Please include which time zone you are in.

Question 11 of 12

Do you have a preference in coach?

Question 12 of 12

Please read through our informed consent, and agree to the terms listed.

Disclaimer - By utilizing MovMed's educational products and coaching, you acknowledge and agree to the following:

1. You are responsible for evaluating your own health and wellbeing and determining whether it is appropriate to undertake the recommended exercises or activities in a training session or online program. If you are aware of any factors which would place you at risk to participate in any way with the coaching or training activities, then you should communicate that with the instructor and seek appropriate medical advice from a doctor before beginning these programs.

2. By purchasing coaching or our programs, you acknowledge and you recognize and are fully aware of the risks and hazards associated with undertaking physical exercise, which may include discomfort or personal injury sustained as a result of engaging in the training.

3. MovMed can accept no liability for personal injury related to participation of their courses or their coaching.

Please read through our informed consent, and agree to the terms listed.

I understand and agree to the terms listed.

I do not understand or agree to the terms listed.

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Seminars and Workshops for All Availability Levels

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