Stretch Therapy Application
I'd love to get to know you more! Please fill in your details below if you're interested in working together to improve your overall wellness!
First Name
Last Name
Email
Phone Number
Where are you located?
How old are you?
Height (ft)
Weight (lbs)
What are your wellness goals?
What are your short term wellness goals (1-4 months)?
What are your long term wellness goals (6-12 months+)?
Any previous injuries or surgeries?
Do you have any health complications or restrictions when it comes to movement?
Any other concerns your specialist should know about?
What physical activities and forms of exercise do you currently engage in?
Which activity level best describes you and your lifestyle currently?
Sedentary
Somewhat Active (1-2x per week)
Moderately Active (3-4x per week)
Very Active (5-6x per week)
How many stretch sessions are you looking to have together per week?
1 day per week
2 days per week
3 days per week
What is your knowledge level when it comes to health, fitness, and wellness?
Advanced
Intermediate
Novice
Other
What are your expectations working together?
Submit Application
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