Return to Play Application

First Name *

Last Name *

Phone *

Email *

Where are you in your ACL recovery process? *

How do you feel your ACL recovery is progressing so far? *

What does being back at 100% look like for you? What activities or goals would you be able to achieve? *

What are you looking to accomplish and the time you need to be ready to perform? *

What do you feel is the biggest obstacle preventing you from reaching 100% recovery? *

List any injuries or surgery yo.u have had in the past or are currently dealing with *

How did you find out about this Return to Play program? *

What is your #1 concern right now? *

The Powers Performance Return to Sport Program requires a commitment of 3+ months and a high level of dedication. Are you prepared to fully commit, take action, and embrace the support and expertise of your ACL specialist to achieve your recovery goals? *

If we’re confident that we can help you achieve the results you want and invite you to join our program, are you ready and committed to investing in your ACL recovery success? *

If you’re accepted into the program, will you need to discuss the financial investment with someone else before making a decision? If so, please check your appointment time to ensure they can join the call. This way, you’ll have all the information needed to decide confidently. If you need to reschedule to include them, please email us to request a new link. *

I understand