Share Your Story

This takes about three minutes. Pick what you're comfortable with, read the plain-language terms, and sign at the bottom. Saying no, or saying yes to only part of it, changes nothing about your care.

01What you're OK sharing

Check everything you agree to. Leave the rest blank.

Written testimonialYour words about working with me PhotosTraining, rehab or on the mats Video or audioClips, interviews, session footage Progress numbersLike your scorecard: pain on the mats, sessions per week General injury descriptione.g. "shoulder," "knee after ACL surgery" Your gym or team nameShout-out to your academy

02How we name you

First name + last initiale.g. "Marcus T." First name only Full name AnonymousInitials or no name at all

Tag my social accountAdd your handle below if you want it tagged Social handle (optional)

03Where it can go

Websitephysiograppler.com Social media@physiograppler posts and stories Email newsletter Paid adsPromoted posts and ads TeachingTalks and courses for other clinicians

Show me before it goes liveI'll send you the final version to approve first

04In your words

Optional. Where you started, what changed, what you'd tell someone in your shoes.

Your testimonial

05The fine print, in plain English

By signing, you understand

It's voluntary. Your care, pricing and access don't depend on signing this.
You're not being paid. No money, discount or gift is given for your testimonial. If that ever changes, it will be disclosed wherever your story appears.
It has to be true. Your testimonial reflects your honest experience. I may trim it for length or clarity but won't change what you meant.
Results vary. Your results are yours. Anything shared will note that outcomes differ from person to person.
This includes health information. You're allowing PhysioGrappler (Roderick Henderson, PT) to use the items you checked, in the places you checked, for education and marketing.
Once it's public, privacy laws no longer protect it. Anyone can see, share or save what's posted.
You can take it back. Email rod@physiograppler.com anytime. I'll stop new use and remove what I control (website, my social posts, future emails). I can't recall emails already sent, printed material, or copies others have saved.
It expires. This release ends three years from the date you sign unless you renew it or revoke it sooner.
You get a copy. Save or print the record you'll see after signing.

06Sign

Full legal name Email

I'm under 18A parent or guardian must sign below Type your full name as your signature I've read and agree to this releaseMy typed name counts as my signature.

Release v1.0 · November 2026

Last step

Send your signed release to Rod so it's on file. Tap Email it to Rod and hit send. Then save a copy for yourself.

Email it to Rod

No email app on this device? Tap Copy and send the record to rod@physiograppler.com from any email account.