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Appointments Only
________________
PLEASE FILL CONTACT FORM TO SCHEDULE YOUR NEXT VISIT
Location
410 W. Main Street suite F Merced, Ca 95340
@rewirebiomechanics
Mail
rewirebiomechanics@gmail.com
Phone
(209) 285-9062
Welcome!
First & Last Name
Email
Phone
Date of Birth
How would you like to be contacted?
Are you in pain?
Yes
No
If yes, please elaborate on your pain.
Are you an athlete?
Yes
No
If yes, what sport do you play?
Do you have any of the following: (check all that apply)
Disk Herniation
Nerve Pain
Sciatica
TBI
Stroke Recovery
High Blood Pressure
Nervous System Disorder
Epilepsy
Arthritis
Pregnant
Post-Partum
Scoliosis
If other, please elaborate.
Are you looking to become more athletic and improve your Physique?
Yes
No
Are you wanting to adopt a healthy holistic lifestyle and nutritional habits?
What are the best days/times for you to train? (limited availability)
How much are you willing to invest in a coaching relationship?
$80-$120 per month
$121-$300 per month
$301-$600 per month
Leave us a message
CANCELLATION/RESERVATION POLICY- A deposit of 45% of the total for initial assessment fee will be needed to successfully book and schedule. No-shows or late cancellations will incur a 100% charge. This policy ensures other clients are able to access the services rather than being put on a waiting list or turned away. Please type "i agree" Below.
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