Qualitative Intake - Stretchzone

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Please indicate the main areas that you would like to improve/work on your body.(Required)

Neck

Shoulders

Chest

Quadriceps (Front of Thighs)

Upper Back

Lower Back

Hamstrings

Calves

Hip Flexors

Gluteus Muscles (Rear end)

Rate your overall wellness on a scale of 1-10.(Required)

Rate your current activity level on a scale of 1-10.

Main Goal:(Required)

Initial ROM assessment of hips and hamstrings.

Left Hip

Right Hip

Left Hamstring

Right Hamstring

Please select any imbalances that currently apply.(Required)

90 - 90 Imbalance

Side to Side Imbalance

Hip to Hamstring Imbalance

Other Imbalance/Not Applicable

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