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Covington

FAST Intake Form

Step 2

1️⃣ What is your primary reason for booking?
2️⃣ Which areas are you most interested in addressing?
3️⃣ How long have you been experiencing this?
4️⃣ Do you have any recent injuries, surgeries, or medical conditions we should be aware of?
Are You On Any Medications?
Are You Currently Under The Care Of Other Licensed Or Certified Professionals?

Release, Disclosure & Assumption of Risk

I understand that Fascial Alignment Stretch Therapy is a non-medical wellness service. Practitioners are not medical doctors and do not diagnose, treat, or prescribe medical conditions. This service is not a substitute for medical care, and I am responsible for consulting a qualified healthcare professional for any medical concerns.


I acknowledge that participation involves gentle physical movement and stretching and assume responsibility for my own participation, releasing the practitioner and studio from liability except in cases of gross negligence or willful misconduct.


By booking this session, I confirm that the information I provide is accurate to the best of my knowledge and that I voluntarily choose to participate.

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