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.
Where does it hurt?
Back
Low Back
Knee
Leg
Neck/Shoulder
Foot/Ankle
Hip
Pelvic Region
Arm/Wrist/Elbow
Head/Jaw
Headache/Migraine
Muscle Injury From Sports/Exercise
Not Sure Where It's Coming From
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What Concerns You The Most That Makes You Want To Consider Physical Therapy?
I’m dealing with a current injury
I want to improve my performance
I’m here for injury prevention
Other (please specify)
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How Long Have You Suffered or Worried?
Less than 1 month
1-3 months
3-6 months
Over 6 months
It’s an ongoing issue
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Main Goal Of Using Our Specialist Service
Ease Pain
Ease Stiffness
Get Active
Stay Active
Avoid Painkiller Dependency
Find Out What's Wrong
Stay Healthy & Get Fixed BEFORE Pain Gets Worse
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