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Please answer everything to the best of your ability. This information is confidential and is solely used for the purpose of giving you the best care and experience.  

Please fill out form below. 

Client Information

Health History 

Do you exercise regularly?
Do you currently have pain?
Please check boxes of areas where you've had any past or recent injures.
Do you have a hip or knee replacement?
Do you have an spinal fusions?
Do you have Scoliosis?
Have you been diagnosed with Osteoperosis or Osteopenia?
Are you pregnant or looking to become pregnant in the near future?
Do you smoke?
Do you have high blood pressure or any heart related condition?

Terms and Conditions

I agree that the health intake form is complete to the best of my knowledge. And that I have made Laura Sifuentez aware of any health or physical conditions that would affect my ability to exercise. 
Laura Sifuentez will not be held responsible for any information not disclosed that could lead to injury. 

I understand that If I have pain, injury, an existing medical condition, or have undergone recent surgery, I will get clearance to exercise from my physician before resuming activity with Laura Sifuentez.

I agree that if I experience pain in any class or session, I will stop doing the exercise immediately and Laura Sifuentez will not be held responsible for injuries that occur.

I assume all responsibility of the risk involved.

These exercises are not medical advice and are not intended to replace any medical advice. 

Cancellation Policy 

I understand that all Virtual Classes and One-on-One sessions have a 12-hour cancellation policy and all In-person Classes and One-on-One sessions have a 24 hour cancelation policy.

I agree that if I fail to notify Laura Sifuentez of the cancellation via text or email within hours stated in the policy above I will be charged the full amount of the session. 

Please send all X-rays and MRI images to  before the consultation call. 

Thank you for submitting.

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