First Name
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Last Name
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Where Does It Hurt?
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Please select
Lower Back
Upper Back
Neck
Shoulder/Arm
Knee
Hip/Groin
Foot/Ankle
Elbow
Wrist/Hand
Pelvis
Pregnancy Related Problem
Women's Health Problem
I'm not sure
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How Long Have You Suffered?
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Please select
A Few Days
1-2 Weeks
2-4 Weeks
1-3 Months
Long Enough
Seems Like Too Long (years)
Haven't - This is Prevention Not Cure
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What does it stop you from doing?
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What concerns you most?
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Please select
Not Knowing What's Wrong
Depending Upon Painkillers
Losing Mobility or Independence
Risk Of Needing Dangerous Surgery
Unable To Do Things I Could Do Before
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Primary Reason for Wanting to Sample Physio?
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Please select
I'm new to Physio & not sure what to expect.
I was let down by another Physio in the past & would like to see how good you are before I commit.
I'm not sure if Physio can even help me.
I'd like to get a feel for what you can do to help me before I commit to a paid appointment.
The NHS let me down - this way confirms that I'm not going to be left feeling the same way.
It's just easier for me doing it this way.
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The Main Goal You Would Like Us to Help You Achieve?
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Please select
Ease pain
Ease stiffness
Get active
Stay active
Avoid painkillers dependency
Find out what’s wrong
Stay healthy & get fit before health problems stop me
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Email
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Phone Number
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