Movement History Form
Use this form to begin your Movement Analysis. After I receive your completed form, I will contact you within 72 hours to schedule your free 30-minute analysis.
Movement Optimization begins with a detailed analysis of your unconscious movement habit patterns. During your analysis, I will review your movement history and analyze your movements.
Then, I'll will create a personalized movement plan that includes hands-on neuromuscular repatterning and Essential Movements that you'll practice at home.
Briefly describe the movements you want to optimize (i.e. sport, musical instrument, job-skill, etc.).
Briefly describe the limitations you are encountering.
How frequently do you practice your skill?
Briefly describe any injuries you've had in the past.
Briefly describe any physical discomfort you are feeling now.
Movement Optimization may require changes to your training routine, diet, stress management, and exercise, and may include a period of time when your performance declines. How willing are you to make substantive changes where necessary?
How did you find out about Middleway Method
Referral from a friend
Referral from a health care professional
Arcata Massage Collective
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Please use the space below to ask questions and share important information that was not covered in this questionnaire:
A copy of your responses will be emailed to the address you provided.
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