STRETCHING PRACTITIONER QUESTIONNAIRE

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.

First Name

Last Name

Email

Phone

Stretching Pre-Screen Assessment

Open Ended Questions

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