Prenatal & Postpartum Self Assessment

Name*

First Last

Email*

What age range do you fit into?*

I am younger than 20

I am 20-29 years old

I am 30-39 years old

I am 40-49 years old

I am 50 or older

Do you:*

(Check all that apply)

Feel like you’re losing strength throughout your pregnancy

Want to know how to reduce aches and pains in pregnancy

Want guidance navigating recovery after a C-section

Want assistance regaining strength postpartum

Feel overwhelmed finding time for yourself while taking care of a little one

Experience incontinence, leakage or urgency to head to the bathroom at any time

Hold stress in your body (shoulders, neck, back…)

Have a physical goal you would like to achieve... lift my toddler without back pain, play with my kids easily, build my core strength, return to my favorite sports activity, run a 5K, etc.

Have a mental goal you would like to make progress on...reduce stress, learn a relaxation technique, reduce risks of depression, etc.

Are you:

(Check all that apply)

Would you:

(Check all that apply)

Like to gain more knowledge about how movement can help during labor

Like to have a consistent exercise routine

Like to have an accountability partner or group for your wellness goals

Like to find out more about how personal training can support you on your wellness journey