Free Assessment

Free Assessment Questionnaire

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Assessment Questionnaire

Do you have any acute or chronic injuries? Have you had any orthopedic surgeries or relevant surgeries as it relates to a medical fitness program? Please describe in detail:

What kind of support are you looking for? Choose from the list:

What enjoyable activities has your pain or injuries kept you from doing? Please describe:

What do you feel is your biggest obstacle in dealing with your pain or injury? Please describe:

What it is that you suffer from day to day with your pain or injury? What can’t you do? What are your limits? How has it affected you or your loved ones? Please describe:

What is your current approach with your treatment of your pain or injury? Please describe:

How long have you been using your current approach in your treatment of your pain or injury? Please describe:

How much of your own money have you already spent trying to deal with your current situation? Please describe:

If you have had a surgery that has affected your ability to improve your fitness? Please describe:

On a scale of 1-10 how motivated are you to begin a medical fitness program?

Is there anything else you would like us to to be aware of that wasn't listed here?

How did you hear about us?

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