Prospective Client Information Form
Please read CAREFULLY before filling out this form. Please be thorough in your response. This is NOT a commitment and DOES NOT guarantee you working with me as space is limited.

What you get:
- Work with someone that specializes in ACL rehab and have all of your questions answered!
–Initial consultation to get to know you, your medical history and your goals to develop your personalized ACL training program.
–Personalized program catered to your individual goals and needs
–Virtual movement assessments
–Unlimited e-mail support to address program questions

Cost:
$150 per hour or $90 per half hour

Premium option available: $350 per month. You get more consistent feedback with weekly check ins and a monthly program personalized for you.

1) This is for TRAINING purposes only. This is designed specifically for athletes and active adults who are looking to improve their strength, lose weight, improve endurance and overall fitness.
2) This is not meant for medical purposes, if you are dealing with any severe injuries and are unsure if you should start this level of training, please consult with a local medical professional.

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Name *
Email *
Phone number
How may I contact you? *
Instagram Handle
Gender *
Date of Birth *
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Where are you from? (city, state)
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