YOU | Shift Exercise Physiology

First name

Email

Number of years with injuries or chronic conditions

Brief summary of your injuries or chronic conditions

Would you be interested in taking steps to improve these areas?

What treatment have you had for the injuries or chronic conditions previously?

What physical, mental and emotional impact do these injuries or chronic conditions have on your daily life?

What are your goals? Short, medium and long term goals

Thanks for your time!

A life fulfilled is a life filled with constant learning, adapting and growth.

Whether you are ready to book in with us or not, we would love to hear from you, learn about you and learn from you.

Here are some prominent questions that we think about regarding behaviour change and exercise.

Feel free to give as much or as little information as you feel you'd like to.

We can't wait to hear it.

How much do you believe the emotional support will benefit you, on top of the physical guidance provided?

Age

What mental and emotional impact do the injuries or chronic conditions have on your daily life?

What are your beliefs regarding your pain levels, your injuries or your chronic conditions?

If no injuries or chronic conditions are present, do you have any niggles you would like to improve?

Given the amount of time you have experienced any niggles, injuries or chronic conditions, how long would you hope and expect recovery to take?

Express Quality Movement