טופס הצטרפות לתוכנית אימון אונליין

Online training registration form

With Maayan Eliasi

Welcome!

This form is designed to help me get to know you better, so that I can tailor the program and support to your personal needs and goals. I respect your privacy - all information will be kept confidential. Feel free to skip any question you do not feel comfortable answering.

Make sure your entire body is in the picture from head to toe. Take a picture in a swimsuit or sportswear that allows me to see your body clearly, in good lighting, and in a place where the background is relatively free of objects.

First and last name (or preferred name)

Which program would you like to join?

Training

Nutrition

Combined training and nutrition

date of birth

Month

Day

Year

Gender (feel free to let me know how you would prefer me to address you)

male

female

other

Mobile number

Country of residence

height

Weight (if measuring weight doesn't feel comfortable to you, you can skip it for now)

What are 2-3 main goals you would like to achieve through our work together? (Goals can be related to a feeling, an experience, a skill, or anything else that is important to you)

Why is achieving these goals important to you?

How would you describe your relationship with your body right now? How would you like to feel?

How would you like to feel?

Do you have any health conditions, injuries, or physical experiences that you would like me to know about before we work together? Any information you share will help me tailor the program best for you.

Are there things that might be a challenge for you in achieving your goals? (e.g., schedule, access to equipment, environmental support, or any other factor)

How many steps do you take per day? Or what is your natural activity level? If you don't have a pedometer, you can check on your mobile phone, and you can also try to describe to me, for example, how many hours of sitting at work? Do you have to walk to work? Are there stairs in the building?

Some people find certain situations (such as touch, certain positions, noisy environments, or other experiences) challenging or unpleasant. Is there anything you think is important for me to know and be sensitive to when building the program?