Get In The Game,

Stay In The Game,

Dominate The Game!

Our athlete program is designed to help middle and high school students build whole-body strength, reduce injury risk, and train with purpose. All sessions are coached by medical and performance professionals.

For Middle School and High School Athletes:

Has this athlete been a PEAK member or Performance PT patient in the last 12 months?

* $50 discovery/initial consultation fee will be added for all athletes who have not been a patient at Performance PT or a PEAK athlete in the past year

For all youth athletes (4th & 5th graders Discovery Visit NOT required)

PRE-DISCOVERY FORM

Parent's Name / Contact Number / Email

** Parents enrolling multiple children can get $50 voucher per additional child upon enrollment to the program.

Athlete's Full Name *

Athlete's Phone Number *

Athlete's Email *

Age

School

Sports Played

Prior Injuries?

Yes

If yes:

Date of Injury

Current Status

Was it treated?

Yes

Medical or PT Provider Seen?

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This form is secure and confidential. All personal health information is protected under HIPAA regulations and will be used solely to assess athletic readiness and customize your care.

Which program are you enrolling in?

Youth (4th & 5th grade) $150/month

Middle School (6th-8th grade)$175/month

High School and College$200/month

(419) 763-6349

[email protected]

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