Renue Athletic Edge: Pre-screening Questionnaire

Thank you for your interest in the Renue Athletic Edge program! Please fill out the following questionnaire before your visit to help your therapist tailor your assessment to your needs.

Comments

This field is for validation purposes and should be left unchanged.

Personal Information:

Name(Required)

Age(Required)

Gender(Required)

School(Required)

Grade(Required)

Sport Information:

What sport(s) do you play?

How long have you been playing?

How often do you train or practice?

Health and Medical History:

Have you had any injuries or surgeries in the last 5 years? If yes, please specify the type of injury and/or surgery and provide dates for each episode.

Do you have any health conditions that may affect your testing (e.g., asthma, diabetes, heart conditions)? If yes, please list.

Are you taking any medications or supplements? If yes, please provide details including the specific medication/supplement, dosage and frequency.

Are you currently experiencing any pain or discomfort? If yes, please provide location and duration of symptoms.

Performance Goals:

What are your performance goals for this program?

Are there specific areas you would like to improve (e.g., strength, agility, endurance)?

Baseline Assessment:

Have you had any previous assessments for strength, agility, or endurance? If yes, please provide details.

Are you currently following any training or conditioning program? Please provide details on type and frequency of training.

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Renue Athletic Edge: Pre-screening Questionnaire

Au Gres

Auburn

Bay City - Dow Bay Area Family YMCA

Bay City - East

Bay City - West

Bridgeport

Caro Hooper

Caro M81

FRANKENMUTH

Freeland

MIDLAND

Oscoda

Saginaw, Bay Rd

Saginaw, State St

Saginaw YMCA

SHIELDS

TAWAS

Please select an option below for us to best direct your call. CORPORATE OFFICE - (989) 450-3341

Please select an option below for us to best direct your call. AU GRES - (989) 254-6360

Please select an option below for us to best direct your call. AUBURN - (989) 662-8855

Please select an option below for us to best direct your call. BAY CITY- EAST - (989) 892-4557

Please select an option below for us to best direct your call. BAY CITY – WEST - (989) 402-1215

Please select an option below for us to best direct your call. BAY CITY - DOW BAY AREA FAMILY YMCA - (989) 414-1399

Please select an option below for us to best direct your call. BRIDGEPORT - (989) 272-4500

Please select an option below for us to best direct your call. CARO HOOPER - (989) 672-5112

Please select an option below for us to best direct your call. CARO M81 - (989) 231-5950

Please select an option below for us to best direct your call. FRANKENMUTH - (989) 480-8872

Please select an option below for us to best direct your call. FREELAND - (989) 573-8266

Please select an option below for us to best direct your call. MIDLAND - (989) 423-1240

Please select an option below for us to best direct your call. OSCODA - (989) 254-6455

Please select an option below for us to best direct your call. SAGINAW – BAY RD - (989) 401-5282

Please select an option below for us to best direct your call. SAGINAW – STATE ST - (989) 355-1010

Please select an option below for us to best direct your call. SAGINAW YMCA (by appt only) - (989) 355-1010

Please select an option below for us to best direct your call. SHIELDS - (989) 401-4791

Renue Athletic Edge: Pre-screening Questionnaire