JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Shin Splints pre-screening - June 30; 4-7pm
Please fill out and submit this form prior to your Shin Splints Screening with Dr. Sonia Lucas. Also be sure to SCHEDULE your appointment by clicking the link at the end of this form.
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
How did you hear about the screening event?
*
Social Media
Newsletter
Word Of Mouth
Other:
Do you experience pain along the length of your shin bone?
Yes
No
Clear selection
Do you feel shin pain at the beginning of a workout that disappears while exercising, only to return during the cool-down period?
Yes
No
Clear selection
Does your shin pain remain during exercise and lasts for hours or days after stopping the pain-inducing activity?
Yes
No
Clear selection
Have you recently increased the speed, mileage, intensity, or duration of your workouts/runs?
Yes
No
Clear selection
Please be sure to have this form filled out prior to your appointment. Click below to schedule your appointment.
https://calendar.google.com/calendar/u/0/selfsched?sstoken=UUlxN0lULUZYUFVWfGRlZmF1bHR8ZjY0MWJlODY4N2NjNjNhODEyMGM4OTE0NTJiNjFmODM
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Fleet Feet.
Report Abuse
Forms
