Align Academy Intake Form First Name * First Name Last Name * Last Name Email Address * Email Address Phone Number * Phone Number CURRENT HEALTH STATUS CURRENT HEALTH STATUS Do you currently take any medications or supplements? If so, please list. Do you currently take any medications or supplements? If so, please list. Are you currently dealing with any injuries? Are you currently dealing with any injuries? EXERCISE AND ACTIVITY HISTORY EXERCISE AND ACTIVITY HISTORY Thank you!