FST Intake Form.docx 2026

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  1. Click ‘Get Form’ to open the FST Intake Form in our editor.
  2. Begin by filling out Part 1: Basic Information. Enter your name, gender, date of birth, age, email, contact number, and address accurately.
  3. Move to Part 2: Session Information. Clearly state your main reason for therapy and specific goals. Mark any symptoms on the provided figures and answer questions regarding medical supervision and tests.
  4. In Part 3: Physical/Lifestyle Factors, provide details about any supportive braces, chiropractic treatments, exercise habits, and how these impact your symptoms.
  5. Complete the Medical History section by listing any diagnosed health problems, medications, supplements, and any relevant injuries or surgeries.
  6. Finally, review the waiver section carefully. Ensure you understand all terms before signing and dating the document at the bottom.

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