EAD Intake Form

Welcome to the GR Performance Team!

Athlete Name*
Athlete Email*

This email will be used to set up their training account. The athlete must be able to access it.
Date of Birth*
DD slash MM slash YYYY
Injury History
Please describe any significant past injuries.
Equipment*
What type of facility will you use to perform your workout?
- Select All
- No Equipment
- Home Gym
- Commercial Gym
- Performance Gym
Equipment
Please describe the equipment if necessary
Training Goals*
What are your primary training goals for this program?
Training Experience*
What is your previous training experience?
Movement Assessment Video*
Drop files here or

Max. file size: 300 MB, Max. files: 4.
Please submit a video showing you performing 5 PERFECT Squats, Lunges, Push Ups, and Pull Ups. (If you have issues uploading, please email them to train@garyrobertshpt.com)