Medical and Physical History Questionnaire Do you have a family history of anything that may affect your full range of motion? [Y] [N] If yes, explain: _______________________________________ Have you had any injuries that may affect your full range of motion? [Y] [N] If yes, explain: I sprained my left ankle multiple times, I tore a muscle in my left shoulder, and I have had my right knee lock up multiple times (possible torn meniscus) Have you had any surgeries that may affect your full range of motion? [Y] [N] If yes, explain _______________________________________
Medical and Physical History Questionnaire Do you have a family history of anything that may affect your full range of motion? [Y] [N] If yes, explain: _______________________________________ Have you had any injuries that may affect your full range of motion? [Y] [N] If yes, explain: I sprained my left ankle multiple times, I tore a muscle in my left shoulder, and I have had my right knee lock up multiple times (possible torn meniscus) Have you had any surgeries that may affect your full range of motion? [Y] [N] If yes, explain _______________________________________