Athlete Intake & Biomechanical Profile | Integrix Health StructureIQ

Section 1 of 7

Personal Information

Your identity and contact details are used to create your Kinetisense athlete profile.

First Name *

Please enter your first name.

Last Name *

Please enter your last name.

Date of Birth *

Please enter your date of birth.

Age * Enter your current age in whole years.

Please enter a valid age (8–99).

Biological Gender * Required for Kinetisense normative data benchmarking.

Male Female

Please select a gender.

Athlete Mobile Phone *

Please enter a phone number.

Are you under 18 years of age? *

Yes — I am under 18 No — I am 18 or older

Please select one.

Section 2 of 7

Parent / Guardian Contact

Required for athletes under 18 years of age.

Parent / Guardian Full Name *

Please enter the parent or guardian's name.

Parent / Guardian Phone *

Please enter a phone number.

Section 3 of 7

Athletic & Sport Profile

Used to contextualize your movement data against sport-specific benchmarks.

School, Club, or Organization *

Please enter your team or organization.

Sport(s) *

Please enter your sport.

Position / Primary Event *

Please enter your position or event.

Dominant Hand *

Right Left

Please select your dominant hand.

Dominant Kicking Foot *

Right Left

Please select your dominant foot.

Section 4 of 7

Body Measurements

These dimensions allow the Kinetisense AI to accurately scale joint centers, calculate torque, and benchmark your data against population-specific norms.

Height * Enter in feet and inches — e.g. 5'11"

Please enter your height (e.g. 5'10").

Weight (Pounds) *

Please enter your weight in pounds.

Section 5 of 7

Prior Injury & Musculoskeletal History

Identifying previous structural injuries allows the clinical software to map hidden compensation patterns during your functional movement screening.

Are you currently experiencing any active pain, joint stiffness, or muscular discomfort? *

No Yes

Please select one.

If yes, describe location and intensity (e.g. "Left knee, 4/10"):

Surgeries in the past 12 months? *

No Yes — please list below

Please select one.

Surgery details:

Diagnosed concussion or head injury? *

No Yes

Please select one.

Approximate date of most recent concussion:

Section 6 of 7

Pre-Screening Checklist

Crucial for scan accuracy — the Kinetisense AI must clearly detect your body landmarks. Check every item below to confirm you are ready to step up to the sensor.

Required Equipment & Dress Rules * All four items must be acknowledged before proceeding.

"Tight & Bright" Clothing: I am wearing form-fitting athletic wear that contrasts with a plain background. No Loose Garments: I have avoided baggy hoodies, sweatpants, or loose shorts. Hair Tied Up: Long hair is secured tightly back in a high ponytail, away from neck and shoulders. Accessories Removed: I have removed hats, sunglasses, smartwatches, jewelry, and loose masks.

Please acknowledge all four preparation items to continue.

Section 7 of 7

Consent & Performance Waiver

By checking this box, I provide my formal consent to the terms of the Integrix Health Performance Waiver above.

Full Legal Name — Digital Signature * Type your full name exactly as it appears on your ID.

Please type your full legal name to sign.

Today's Date *

Please enter today's date.

Athlete Intake &Biomechanical Profile

Profile Submitted!

Personal Information

Parent / Guardian Contact

Athletic & Sport Profile

Body Measurements

Prior Injury & Musculoskeletal History

Pre-Screening Checklist

Consent & Performance Waiver

Athlete Intake &
Biomechanical Profile