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New Client Forms


All clients are required to fill out the form below before their first session. Anyone who has been under a physician’s or a physical therapist’s care within the past 12 months will also need to obtain a signed physician’s release from your doctor stipulating any directives regarding movement programming and/or any limitations that should be honored within your training program.

Name *
Name
Have you been to physical therapy in the last 12 months?
Hypertension? *
Pregnancy:? *
Osteoporosis? *
Weight Loss or Gain? *
Heart Disease? *
Broken Bones? *
Previous Surgeries? *
Medical Waiver/Release - Please Initial
Cancellation Policy