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Stretching Pre-Screen Assessment
Open Ended Questions
Address: 605 E Palace Pkwy Suite D3, Grand Prairie, TX 75050
a.)What kind of problem do you have (e.g., pain, not flexible)?
b.) Do you have problems only when you move or also at rest?
c.) Please list any injuries, surgeries, or physical problems you have experienced in the past. If you have had more than one, list them chronologically, starting with the most recent.
d.) Please list any current health problems, complaints, injuries, or current diagnoses made by a health professional.
FILL OUT THE NECESSARY INFORMATION
First Name
Last Name
Email
Phone
Birthday
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