R4P Online Rehab Consultation Form

REHAB 4 PERFORMANCE

Please Fill Out This Short Questionnaire Prior To Your Appointment So That Your Therapist Has All Of Your Details
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Country of Residence
Describe Your Problem that you are looking for help with?
What is it stopping you from doing?
How long has it been going on for?
What activities/movements/hobbies that are important for you to return to?
What does your current training week (gym, sport, activity levels) consist of?
Have you had any injuries in the past (ankle sprains, surgeries, etc.)? If the answer is yes, please specify left or right and approximate year.
Have you attended any form of treatment for this before (Physio, Chiropractors, Sports Therapists etc)?
If you have had any scans (x-rays, MRI, CT scan etc), please upload in pdf format

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Do you have any other past medical history (Allergies or Underlying conditions)
Upload photos of gym space (if applicable)

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What gym equipment do you have or do you have access to?
Do you have any type of wearable fitness technology? If so please specify below (e.g Apple Watch, FitBit, Whoop, GPS)
CONSENT: By ticking this box, I consent to the general T&Cs and specifically consent to undertake online assessment and treatment guided by Cathal Corr.
FAQs

What Equipment Do I Need?

All you need is a device with a webcam and a microphone so that you can connect over video call. You will also need to be connected to the internet.

Will I Need To Do Anything On The Coaching Call?

You may be asked to stand up and perform certain movements, and may be coached through some exercises, so wear suitable clothing (eg shorts or tracksuits).

Do I Need To Download Anything For The Call?

You will be sent a link to join the call prior to your appointment. We advise you click that as soon as it arrives and download any relevant software to avoid delays.
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REHAB 4 PERFORMANCE