Sierra Center for Peak Perfromance

PERSONALIZED AFFIRMATIONS

Use this form to set goals and action steps and Dr. Relax will turn your goals and action steps into powerful, affirmations that will motivate, inspire and reinforce your efforts to reach your goals.

To ask Dr. Relax to create a set of personalized affirmations specific to you and your unique circumstances, simply complete this form and click on "Send" at the bottom.

If you are not sure how these affirmations can help you see: http://www.drrelax.com/ezine1.htm#3

What is your first name?
What is your last name?
What is your gender?
What is your age?
Are you an active competitor?
What is your sport or interest?
When does your season begin and end or how soon do you want to get started?
What is the date of your next important competition or challenge?
What are your process goals? Give at least 4 Goals.

Process goals such as: To practice more often or have more calm, focused, positive self-talk for example.

Avoid Outcome goals such as: To win or get stronger for example.		 1.
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What must you do to achieve each of the goals stated above? (What actions must you take?)* Note that Step 1 is the action you must take to achieve Goal 1 and each step should be paired with each goal above. 1.
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What is the single biggest challenge to you reaching your goals?
What feelings or emotions do you have when competing and everything is perfect? What feelings do you or will you associate with achieving your goals? (Try to name more than four if you can.) 1.
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What specifically do you believe my consultation and training will help you to improve?
Name three athletes or people you admire 1.
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Please Note: If you are under 18 years of age your parent or guardian must provide verbal permission for your participation so please make sure your phone number is valid and includes area code.