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.

It is important to know:

Along the way, you will be able to develop abilities and feelings that will be expressed in broad areas of your life: a sense of autonomy and free choice, dealing with challenges as part of your routine, a sense of strength and power, self-confidence, flexible and efficient daily functioning, the ability to cope with pain and build endurance, better control in stressful situations, experimenting with new things, improving performance and muscle mass, self-regulation, self-acceptance, enjoyment and creativity.

All of these can improve when you adjust the right dosage for you – one that allows you to grow at your own pace, in a way that feels safe and empowering to you.

To make the journey complete, if you are not accompanied by emotional therapy and such a need arises, I would recommend contacting an appropriate professional. I invite those of you who are in a therapeutic setting to share your choice of training with me with your therapist.

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?

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?