FREE FIRST VISIT KIT
Walking into a first appointment?
Everything fits on one page: your whole injury and surgery history, 5 questions worth asking before you book, a baseline you can measure, and a stop rule you set in advance. It’s right here, free, with no email required. Print it or save it as a PDF straight from your browser.
Go to the free kitWhy bring your whole history?
A practitioner working from the fascial model is looking for what’s driving the pain, and that can be decades old and nowhere near where it hurts. An ankle sprained at 17 can matter to a knee at 45.
You’re the only person who has that history. Written down, it turns a first appointment spent remembering into one spent testing.
The kit comes from Unlocking True Relief by Keryn Gold, PhD, MBA, which maps what the research on Fascial Counterstrain does and doesn’t show, and what else holds up under a clinical trial.
THE KIT
Your First Visit Kit
To print it or save it as a PDF, press Ctrl+P on Windows or Cmd+P on a Mac. Fill it in before you book.
1. My timeline, oldest first
Fractures, sprains, surgeries, car accidents, falls, childbirth, concussions and significant illnesses. Include the ones that seem irrelevant.
| Year | What happened | Still notice it? |
|---|---|---|
2. Symptoms, including ones that seem unrelated
☐ Bloating ☐ Dizziness on standing ☐ Cold hands or feet ☐ Headaches
☐ Swelling ☐ Sleep problems ☐ Numbness or tingling ☐ Other: ______________
3. My baseline
Pick one movement you can repeat exactly: how far you can turn your head before it catches, how far down your shin you can reach, or how long you can stand before the ache starts.
Movement: ________________________________
| Morning of the visit | Next morning | 1 week later |
|---|---|---|
4. 5 questions before I book
- Which Jones Institute courses have you completed, and do you treat the visceral and nervous systems?
- How long is a first session, and a follow-up?
- What’s the cost per session, and do you bill insurance or provide a superbill?
- How many sessions before we’d know whether this is helping me?
- What would tell you this isn’t the right treatment for my case?
5. My stop rule
If nothing measurable changes after ______ sessions, I’ll stop and reassess.
6. After the visit
What was treated: ________________________________
What changed on the recheck: ________________________________
What to watch for: ________________________________
Where to find a trained practitioner
The Jones Institute directory and the Counterstrain Academy clinic finder both list clinicians by location. Question 1 above is the one worth asking first.
See a physician first for new or worsening weakness, numbness in the groin or saddle area, any change in bladder or bowel control, fever with back pain, unexplained weight loss, a history of cancer, pain after significant trauma, chest pain, shortness of breath, or a new severe headache.
Educational content. Keryn Gold holds a PhD in Biomedical Sciences, not a medical license. Not medical advice.
