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3. Address including postcode *
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6. Height, weight and shoe size *
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7. Current injuries/issues *
8. On a scale of 1-10, 1 being No Pain and 10 being Excruciating, where would you mark your current pain levels?
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9. What treatment have you receive previously for this? *
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10. Typical physical activities – work, sport, recreation? *
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11. Please give details of any other medical conditions or medication that you feel your practitioner should be aware of. *
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12. What outcome would you like to achieve from a PostureFit consultation and treatment? *
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13. I understand I am supplying PostureFit with images, personal information, physical injuries, and physical history information for the benefit of my consultation and treatment.
I understand that I should NOT attend my face to face appointment in the event that I am suffering flu like COVID-19 symptoms.
For online consultations - I will ensure I am in a safe environment free from hazards.
I am aware that PostureFit will store my personal data for medical records purposes.
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