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Online Patient Questionnaire

 

We are asking you to complete new patient questionnaire enabling our clinical and administrative staff to prepare for your first visit and to make your check-in for your appointment quicker and easier.

 

Our questionnaire consists of 7 documents. To complete a document, simply fill out the fields with the requested information. While most of the fields are optional, certain fields, marked by asterisks, must be completed. When you have completed a document please review your entry, click the Submit button to move to the next document. 

 

Please note that the information you will submit will be encrypted for your protection and goes directly to our office. We appreciate the time you will spend providing the information and helping us prepare for your visit.

 

Thank you and please call our office 386-238-9103 or email to info@therealmuscleclinic.com if you have any questions.

 

 

  • By Submitting any information to the below links, you consent to use Electronic Records and Signatures

Parental Waiver
Recurring Payment Plan Authorization Form
Photo/Video Waiver
Personal Trainer Intake Form
Membership Contract
Gym Rules
Liability Waiver Form and Hold Harmless Agreemant

By providing your electronic signature, you have consented to the terms and conditions outlined in all forms.

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