So That We Can Serve Your SPECIFIC Needs, Please Fill Out This Form (it only takes 35 Seconds) And Show 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
Hip
Pelvic Region
Not Sure Where It's Coming From
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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 Dangerous Surgery
Concerns at No Sign of Improvement
Fear of Missing Out on Activities with the Kids
Afraid of Always Having to Deal with Leakage
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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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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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