Online Consultation Questionnaire

Thank you for registering for the online Consultation.
This questionnaire is being sent to you so that we can use the session time effectively.

※※※Please READ  below※※※

✨ This Free Online consultation may take over 120 minutes. Please be aware of the potential extension.  

✨ For individual consultations, we will use  an app called ZOOM. 
     It is a convenient tool that is free and easy to use on your mobile phone or computer.                                               If you do not know how to register the app or how to use it, please contact us.

✨ In order to talk in an environment that is closer to face-to-face, [only those who can show their face can register for this consultation].

✨ Email Addresses such as "icloud.com" and "ezweb.ne.jp" may not be able to receive messages, so if you do not receive a reply within 24 hours, please apply again using a different address.

✨ We will reply in order within 24 hours, so please wait for a while after completing the registration.


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Email *
①Full Name *
②Why did you register for free online consultation? What would you like to get from this online consultation? Please describe in detail. *
③If you never fail, what would be your ideal physical state within 3 months, 6 months and a year? Please list to 3 things you would like to achieve in details.  *
④Why do you want to achieve them? Please describe in detail.  *
⑤What, if anything, are the obstacles to getting those results? (physically, mentally, logistically, financially etc)  *
⑥What and how much have you invested in taking care of your body so far? Please describe in detail.  *
⑦Please, tell us anything else about you. (Where you are base, Family background, professional background, your personality, etc.) *
* The contents of the questionnaire comply with the Personal Information Protection Law. Therefore, no information is leaked. *If you have any questions, feel free to let us know. I look forward to your consultation. *
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