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Intake form
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Name
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Email address
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What services are you interested in?
Please select at least one option.
Active Rehab services (ICBC)
Personal Training
Performance and Rehab
Post-op Rehab
What is your primary goal for seeking rehabilitation or performance training?
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Improve strength
Enhance mobility
Pain management
Recovery from injury
Post-operative recovery
Increase athletic performance
Do you have any existing medical conditions or injuries? if yes, please describe.
Have you previously undergone rehabilitation or training?
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Yes
No
If yes, please provide details about your previous experience.
What is your preferred method of communication?
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Email
Phone
In-person consultation
What is your availability for sessions? please specify days and times.
Additional questions or comments
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