Waiver | Progression-CMTA.com

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NEW CLIENT WAIVER

Health Waiver

Before your appointment, please register with our facility by completing the form below

First Name

Email Address

Last Name

Date of Birth

Do you require a doctor’s permission to participate in fitness-related activities? *

No

Yes

If you answered YES to above, do you have documented proof of your doctor’s permission to participate in fitness-related activites?

No

Yes

Have you had a medical procedure in the past 12 months that would inhibit specific muscle testing/activation, movements, or exercises? *

No

Yes

Initials

Today's Date

I declare that the information I’ve provided is accurate & complete

Thanks for submitting!

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