Reconnect Intake

YOUR RECONNECT INTAKE

Before we begin,

This form gives me a starting point for understanding your body, your movement history, and what you'd like to change over our 12 weeks.

You don't need to know exactly what's causing your symptoms or have the perfect words to describe what you're experiencing.

Just tell me what you notice.

01 Where Are You Now?

What brought you to Align With Amie? What are you currently experiencing in your body?

What tends to make it better?

What tends to make it worse?

02 Your Relationship With Your Body

Are there any areas of your body that feel difficult to connect with or feel clearly?

Are there areas where you feel like you're constantly holding tension?

When are you stressed, busy, or under pressure, what do you notice your body doing?

03 Your Movement History

What does your current exercise or movement routine look like?

What types of movement or exercise have you done in the past?

Are there any movements you avoid because they don't feel good or feel difficult?

What helped? What didn't?

04 Goals

What would you like to change over these 12 weeks?

What would you like to be able to do that you currently can't, don't feel confident doing, or don't enjoy?

If you felt more connected and capable, what would change in your everyday life?

What would make you say at the end of 12 weeks: "This was with it."

Add your text

05 Pregnancy + Postpartum

Are you currently pregnant or postpartum?

Yes

Neither

If pregnant, how far along are you?

If postpartum, when did you give birth?

What type of birth did you have?

Vaginal

Cesarean

Other

Are there any areas of your body that feel particularly different since pregnancy or birth?

Has your healthcare provider given you any restrictions or recommendations regarding physical activity?

06 Your Expectations

What are you hoping I can help you understand about your body?

What are you wiling to practice between sessions?

5-10 minutes most days

10-20 minutes most days

A few times per week

I'm not sure yet

Is there anything you want me to know before we begin?

If your body could feel different 12 weeks from now. what would "different" mean to you?

Thank you for taking the time to share this.

This gives us a starting point.

We don't need to solve everything at once.

We'll start by finding the first connection.