Virtual Check-In/Membership Agreement

You acknowledge that Jordan Seda Physical Therapy, PLLC, a New York professional limited liability company, its owners, agents, or employees will provide the following performance services: (a) movement/wellness coaching (b) programming review. I further acknowledge that performance services and their risks and benefits have been explained to me; performance services may not have the result that I expect, and I have been informed as to other possible services that may provide me a benefit. I have had ample opportunity and time to discuss my concerns Dr. Jordan Seda, PT, DPT, OCS, CSCS, and all my questions have been answered to my satisfaction.

Performance services may be provided remotely, including by phone or email. Performance services are not physical therapy.

I acknowledge that, although Jordan Seda Physical Therapy, PLLC is a licensed physical therapist, rendering performance services does not constitute the practice of physical therapy or any other service for which a state licensure is required. Jordan Seda Physical Therapy, PLLC’s performance services are based upon its owners’, agents’, or employees’ proficiency in and knowledge of how to help clients set and reach their performance goals. Nothing in this policy is intended to limit the ability of Jordan Seda Physical Therapy, PLLC to employ appropriate and lawful physical therapy techniques that its owners, agents, or employees are educated and licensed to perform.  Conversely, nothing in this policy is intended to expand the scope of practice for any activity, treatment, or consultation for which Jordan Seda Physical Therapy, PLLC, its owners, agents, or employees are unlicensed, unqualified, or not lawfully permitted to provide. By signing below, I acknowledge that I understand that I will not be receiving any physical therapy or any other services for which a state licensure is required.