So That We Can Serve Your SPECIFIC Needs, Please Fill Out This Form (it only takes 30 Seconds) And Tell Us EXACTLY How You Want Us To Help YOU… The more we know about you, the better we can help you.
What Is Your Main Concern Or Pain?
Upper/Mid Back
Low Back
Abdominal Pain
Postpartum Recovery
Diastasis Recti
PCOS
Endometriosis
Pelvic Region
Fertility Concerns
Prenatal Care
Birth Preparation
Pain with Intimacy
Hip Pain
Incontinence
Constipation or Painful Bowel Movements
Tailbone Pain
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What Concerns You The Most That Makes You Want To Consider Physical Therapy?
The Pain You Are Experiencing
Not Knowing What's Wrong
Want to Avoid Pain Killers & Medications
Fear of Not Being Able to Stay Active
The Risk of Needing Surgery
Concerns at No Sign of Improvement
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How Long Have You Suffered Or Worried?
Haven't - This is Prevention (Not Cure)
A Few Days
1-2 Weeks
2-4 Weeks
1-3 Months
Long Enough (4+ Months)
Seems Like Too Long (Years)
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Please Choose Your Ideal Day(s) For A Discoveyr
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
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6am
7am
8am
9am
10am
11am
12pm
1pm
2pm
3pm
4pm
5pm
6pm
7pm
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