Name
*
First Name
Last Name
Email
*
Your Pronouns
1. Are you pregnant, postpartum / a parent, or trying to conceive? If yes, in what phase of that journey are you in?
*
2. Are you currently, or have you ever been dealing with any symptoms such as diastasis recti, leaking, heaviness in your vagina or pelvis pain?
*
3. Are you currently, or have you ever been dealing with any other pain/ injuries (e.g. low back pain, hip pain, shoulder pain)?
*
4. Are you currently exercising or moving your body? Why or why not? (NO JUDGEMENT!)
*
5. Why do you want to be exercising? What are your goals around movement for the next 3 months - 1 year?
*
6. What has your relationship with your body, food, and exercise been like? (High level overview is fine!)
*
7. Can you commit to 30-minute virtual sessions once per week?
*
8. Can you commit to being engaged in this flexible program for 3 months?
*
9. My current availability for 1:1 is Tuesdays and Thursdays from 9:30am-4:30pm EST. Would you be able to make this work with your schedule?
*
*Note: there are 2 evening options we can discuss - working 1:1 with my physiotherapy assistant or a small group physiotherapy class
10. The investment for this 1:1 program with Rhonda will be $150 for the 45-minute assessment and $100 per 30-minute weekly appointment. Is this something you can invest your finances and effort in?
*Invoice sent after each session to submit for 3rd party physiotherapy benefits for Ontario residents
