Getting To Know You

Step 1 Of 2: Please Complete This Simple Questionnaire

About the Comfort Call

The purpose of this quick 30-minute call is to answer any questions you may have about the 5 Pillars of Health and Vitality, and explore how they relate to your situation. Essentially, we'll use this time to gain a better understanding of your situation, and determine if the Aligned Body Core system makes sense for you.

Together, we'll map out a plan to get your health back on track. To save time, however, we'll need to know a little about your situation before we have our call.

Complete the questionnaire of this page to get started.

Here's what you can expect:

The session will be conducted over Skype or telephone. (If you're in a country other than US/Canada, Skype is the preferred method.)
We'll review your responses to the following questions
And generate valuable insights about what to do next.

Other than that, I'm looking forward to help you move forward with your health. If that works for you, kindly complete the questionnaire on this page.

—Darrell Derksen, Founder

First Name*

Last Name*

Email*

Phone*

1. How long have you been experiencing pain?*

2. What is this pain preventing you from physically doing?*

3. What activities have you had to give up, if any?*

4. What conventional methods of pain relief have you attempted?*

5. What types of activities would you like to engage in that you've been unable to enjoy or pursue?*

6. What types of specialists have you seen already?*

7. On a scale of 1 to 10, how would you assess your pain? *

8. From your perspective, what do you feel has caused this situation?*

A. Emotional

B. Physical

C. Psychological (mental)

D. Environmental (toxins)

9. Why are you considering a different approach now?*

Step 1 Of 2: Please Complete This Simple Questionnaire

Complete the questionnaire of this page to get started.

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