TSG – Injury Management Injury and Load Management Coaching Name* First Last Email* Enter Email Confirm Email Injury and Load Management Coaching Terms of Service | Liability Release Information gathered and provided during any consultation is to help tailor programs around injury. This may also allow for better application of exercise programs around injury. However, the contents of this document/consultation should not be taken as medical advice. Any information gathered is to help the client improve performance and key aspects of programs previously designed by their respective coach. It is not intended to diagnose, treat, cure, or prevent any health problem - nor is it intended to replace the advice of a physician or other medical professional. This services is not to be considered Physical Therapy. Always consult your physician or qualified health professional on any matters regarding your health. All services received are in conjunction with The Strength Guys Inc., and will follow any release of liability previously agreed to. Agree to Terms of Service and Liability Release* AGREE To DECLINE, please exit form. If you would like further information, please email billing@thestrengthguys.com .Do you have tingling, numbness, novocaine or pins and needles anywhere?* No Yes Describe Q6Please provide details of your tingling, numbness, novocaine or pins and needles.Have you had any recent unexplained weight loss, weakness, night pains or coordination problems?* No Yes Describe Q8Please provide details of your unexplained weight loss, weakness, night pains or coordinations problems.Have you had fever, chills or general sick feeling when this issue started?* No Yes Describe Q10Please provide details if you had fever, chills or general sick feeling when this issue started.Is this issue constant or intermittent?* Constant Intermittent Describe Q14Please provide further information if possibleHow long have you had this issue?* Do you see anyone medical profession or non for this issue?* Yes No Describe Q17*Please list these and what you have done.What types of activities throughout the day seem to make this issue worse if any?What types of activity throughout the day seem to make this issue better if any?Coach Preference Emily Dominic Either one is fine Please be advised appointments based on availability. If your preferred coach is unavailable, you may be asked to work with the other coach.Are you currently a TSG athlete?* No Yes Who is your coach?* Do you live in Canada?* No Yes Where do you live?* Select A Service* Single Consultation One Monthly Appointment With Weekly Check-ins Have someone contact me
