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1. Rate your current activity level on a scale of 1-10:(Required)
2. Rate your current pain/discomfort on a scale of 1-10:(Required)
3. Rate your progress towards your goal on a scale of 1-10:(Required)
4. Has your goal changed since the last evaluation?(Required)

5. Select areas you would like to continue to address:

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

to be entered by stretch practitioner:

Select any imbalances that apply:(Required)
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