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Please complete this form at least 24 hours before your Assisted Stretch Session, so I can review your information and create a focused plan for you.

Client Details

Birthday
Month
Day
Year

Assisted Stretch Intake Form

2. Where does your body feel most restricted or uncomfortable right now? (check all that apply)
4. How has your energy been lately?
5. How has your sleep been over the past 2 weeks?
6. What is your current weekly movement like?
7. What would feel like a "win" when you are done with your session?

Consent & Acknowledgement

I understand that assisted stretching involves guided movement, hands-on-techniques, and physical contact from my Certified Stretch Coach. I confirm that I have shared any relevant health information, will communicate openly during my session, and understand that the session is intended to support mobility, flexibility, and overall wellness. I voluntarily choose to participate and accept responsibility for my experience.

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Melody Moe Fitness is  based out of Watertown, WI

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