Thank you for scheduling your initial consultation.

The next step is to fill out your Free Wellness Assessment: we will learn about your physical condition, your goals and will customize your consultation to address your specific needs.

Wellness Assessment

What OsteoStrong benefits do you desire? (check all that apply) *

Increase Bone Density

Increase Muscular Strength

Increase Energy

Eliminate / Reduce Joint & Back Pain

Strengthen Immune System

Improve Balance & Agility

Improve Posture

Improve Blood Glucose Levels

Injury Prevention

Improve Athletic Performance

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Do you regularly experience pain in any of these areas? (check all that apply)

Lower Back Pain

Mid or Upper Back Pain

Neck Pain

Hip Pain

Knee Pain

Elbow Pain

Shoulder Pain

Wrist Pain

Ankle Pain

Other

On a scale of 1-10, please describe the severity of any painful areas you selected (1 = mild pain, 5 = moderate pain, 10 = severe pain)

What are your current health goals?

How committed are you to achieving these goals?

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What activities do you enjoy?

What obstacles or limitations hold you back from enjoying more of your favorite activities?

What have you tried to do to eliminate these obstacles and limitations?

What are you sacrificing by not fixing this?

How would your life improve if you no longer had these obstacles & limitations?

What would you consider a success?

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