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General Athlete Screening: On Field Rehab
6
Questions
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1
Has your Physiotherapist recommended you receive on field rehab?
YES
Not yet
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2
Are you interested in returning to your sport?
YES
NO
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3
How confident are you in your affected joint?
100% Confident
75% Confident
50% Confident
Less than 25% Confident
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4
Do you have full Range of Motion of your affected joint
YES
NO
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5
I can complete the following
10 Single Leg Squats
30 second plank & side plank
10 Single Leg Hip Bridges
Stand on 1 Leg for 15 seconds
Single Leg Hop for 30 seconds
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6
What is your email address
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