Application Form

Ready to rebuild your shoulder with confidence?

The Rebuilt To Move Shoulder Rebuild program is a structured, step-by-step system designed to help active adults overcome shoulder pain and safely resume strength training, exercise, and the physical activities they love.

This short form will help us confirm that the program is right for you and determine the best path forward for your shoulder recovery. Kevin reads every application personally. No payment at this stage.

* Required
Step 1 · You
Where are you located?*
Step 2 · Your shoulder
1. What best describes your shoulder right now?*
2. How long has this been going on?*
3. What have you already tried?*
Select all that apply.
4. How is it affecting you right now?*
5. What do you want to get back to?*
Select all that apply.
Optional. Diagnosis, surgery date, what makes it worse, what you have been told so far.
Step 3 · Your commitment
7. Do you have access to a gym or training equipment?*
8. How many sessions a week can you commit to?*
9. Are you ready to take the necessary steps to overcome pain and regain your abilities?*
10. Do you currently have the financial resources to invest in a personalized rehab program?*
If you're eligible, Kevin will contact you shortly to assess your situation and offer a personalized plan.