Fill Out & Submit Initial Contact Form Lesson 1 of 0 In Progress Fill Out & Submit Initial Contact Form Additional Member(Required) This is only applicable for those clients who purchased Family PlansEmail(Required) Name(Required) First Last Do you play a sport? If yes, which one is your main one?(Required) No Baseball Basketball Bicycle Motocross (BMX) Bodybuilding Bowling Boxing Car Racing Cheerleading Cricket Dance Diving Fencing Figure Skating Football Golf Gymnastics Hockey Horse Back Riding or Horse Riding Ice Skating Karate Lacrosse Kick Boxing Rock Climbing Rowing Rugby Skateboarding Skiing Snowboarding Softball Squash Swimming Tennis Track and Field Triathlons Volleyball Water Polo Wrestling Other If the sport that you play is not on the list, please put it here: Age(Required)Please enter a number from 1 to 115.Guardian's Name(Required) First Last Guardian's Email:(Required) Do you have any pain? Mobility constraints? Areas of your body where you feel you are leaving performance or athletic potential on the table? Or do you feel like any area of your body is sorer than others & takes longer to recover? If so rate 1-10? (1 = Absolute Worst Of All Time, 10 = Feel No Pain & I feel Amazing 24/7)12345678910What is the #1 place you frequently feel pain or an area mentioned aboveToeAnklesAchillesCalvesKneesHamstringsQuadsGroinsHip FlexorsIT BandsGlutesLower BackMid BackUpper BackLatsAbsShouldersArmsWristsNeckWhat is the #2 place you frequently feel pain or an area mentioned aboveToeAnklesAchillesCalvesKneesHamstringsQuadsGroinsHip FlexorsIT BandsGlutesLower BackMid BackUpper BackLatsAbsShouldersArmsWristsNeckWhat is the #3 place you frequently feel pain or an area mentioned aboveToeAnklesAchillesCalvesKneesHamstringsQuadsGroinsHip FlexorsIT BandsGlutesLower BackMid BackUpper BackLatsAbsShouldersArmsWristsNeckOther If you were to sit in the seiza position, do you have any pain?(Required)Rate your pain from 1 (Worst Pain of All Time) to 10 (No pain at all, feel amazing everywhere when in this position)12345678910 (I have no pain when I sit in this position at all, feels good and I can do it for a substantial amount of time)Why are you here? Become more durable and mobile (Avoid Non-Contact Injuries) Aesthetics without pain Athletic Performance Other Other Are you looking for your fitness program to be tailored towards weight management?(Required) Gain Weight Lose Weight Maintain Weight Neither Are you with one of our affiliated Organizations? Note: Please tap “Mark Complete” after submitting the initial contact form.
