This short diagnostic will help us understand your current state, your goals, and what’s getting in your way.

Fill out each question fully, submit your answers, and then schedule a free consult to receive your personalized roadmap.

Q1: Where are you experiencing the most discomfort or limitation?

Q2. How consistently do you eat mostly whole, plant-based foods (fruits, vegetables, nuts, seeds, whole grains, lean proteins, healthy fats)?

Q3. How would you describe your current physical condition right now?

Struggling with pain or mobility limitations

Stiff or inconsistent — I can train but not at my best

In decent shape but know I could move and feel better

Strong and active, just want to fine-tune performance

Not sure — I just feel off or limited overall

Q4. How well do you manage your nutrition habits — staying hydrated, limiting added sugar, salt, and processed foods?

Q5. How consistent are you with regular exercise — including cardio and strength training each week?

Q6. How well do you include recovery and flexibility work (stretching, mobility, yoga, or active rest) in your routine?

Q7. How well do you manage your energy through sleep and stress — getting adequate rest and using tools like mindfulness or reflection?

Q8. What does success look like for you 90 days from now?

I want to get through my normal activities without pain or limitation.

I want to be in better condition so I can serve my family, friends, and community throughout my life.

Lifting, sports, hiking, or working without hesitation

Training hard, chasing goals, and feeling unstoppable again

Q8 Other

Q9. What’s been the biggest obstacle keeping you from reaching your goals?

I get stuck because of recurring pain or movement limitations

I feel like I’m losing ground and I need more structure and accounability.

I start strong but lose momentum or consistency

I know I can do more, but I don’t have a clear plan or direction

Q9 Other

Q10. How well do you follow a structured program on your own, and how much personalization do you feel you need?

I follow programs well on my own and just need a clear plan to execute

I stay mostly consistent but get better results with occasional feedback and adjustments

I need personalized coaching and accountability to stay on track and make real progress

Q10 Other

Q11. How do you stay accountable when motivation drops?

I tend to struggle — I need a coach to help me stay focused and consistent

I do best when someone checks in and holds me accountable

I rely on habits and discipline — I just need the plan

Q11 Other

Q12 Why now? What made you reach out?

I’m starting to worry this is only going to get worse.

I’ve put this off long enough — I need to take ownership.

I’m ready to train with intention and finally see progress again.

Q12 Other

Q13 Why does Performance Physiotherapy feel like the right fit for you?

I’m looking for someone who understands both pain and function.

I want a plan that respects where I’m at but moves me forward.

I’m ready to be coached by someone who knows how to build long-term resilience and performance.

Q13 Other

Q14 Is there anything else that you feel is important?

Where should we send your custom movement guide?

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