Pitching Evaluation Request
Welcome!  We are excited to help you on your softball pitching journey.  
Fill out this form to request a pitching evaluation from us.  We will customize a set of packages based on your goals and needs for you to choose from.
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Email *
Let's get started.  What is your name and the name of your athlete?
What is her age and pitching experience?
What pitches does she have and currently working on?
What is your main goal with an evaluation (i.e., accuracy problems, need more speed, having pain while pitching, need a tune up, working on a pitch, not sure what to do next, etc.)
Select any of the below that you are wanting out of this evaluation: *
Required
Is there anything else about your pitcher that we would need to know (i.e. previous shoulder surgery/injury, past experiences with certain pitches, question about technique, etc)
Select any additional services that may interest you:
How do you hear about us? 
If someone specific referred you, please list them here.
Thank you for trusting me with your athlete!  You will receive a form detailing out your customized packages.  Once accepted, you will receive an invoice and your to-do list for videos.  We have a specific application that you will be given a code to download.  Expectations on timeframe: 2-3 business days for the package list and 1-2 weeks for the pitching evaluation.
- Dr. Ashley Brignac Domec, D.C.
A copy of your responses will be emailed to the address you provided.
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