Please fill out so I can help support your fitness goals! Name * First Name Last Name Email * Phone (###) ### #### What are your main health + fitness goals? * (e.g., increase strength, improve energy, lose weight, support pregnancy/postpartum, manage menopause, etc.) Do you have any current or past injuries, surgeries, or health conditions I should be aware of? * (e.g., increase strength, improve energy, lose weight, support pregnancy/postpartum, manage menopause, etc.) Have you ever been told by a healthcare provider that you should avoid certain types of exercise? * What is your current activity level? * Sedentary, light activity, moderate, very active—please describe what a typical week looks like. Have you worked with a personal trainer or followed a structured fitness program before? If yes, what worked well and what didn’t? * What kinds of movement or exercise do you enjoy most (or least)? * Are there specific areas of your body, health, or lifestyle you’d like me to focus on supporting? * Examples: core strength, pelvic floor, bone density, balance, energy, stress reduction, etc. Is there anything else you’d like me to know to help support you on your fitness journey? * How did you hear about me? Social Media Friend Family Member Google/Online Followed you from Pelvico Other Thank you!