Name *

Email *

Phone *

Primary Reason for Requesting a Free Consultation *

I’m new to Physical Therapy and not sure what to expect
I was let down by another Physical Therapist in the past and would like to see how good you are before I commit
I’m not sure if Physical Therapy can even help me
I’d like to get a feel for what you can do to help me BEFORE I commit to a full appointment
It’s just easier me doing it this way
I want to understand the Root Cause of my problem before making a decision
I've been told there's nothing that can be done to improve my situation
No elements found. Consider changing the search query.
List is empty.

Where Does It Hurt (or other issue)? *

Not sure where it's coming from
Lower Back Pain
Sport or Work-Specific Injury
Sciatica/Nerve Pain
Knee Pain
Shoulder Pain (Rotator Cuff)
Neck Pain and/or Headaches
Pre or Post-Surgery Issue
Foot/Ankle Pain
Balance & Fall Prevention
Sport or Work-specific Injury
No elements found. Consider changing the search query.
List is empty.

How Long Have You Dealt With This Issue? *

A few days
1-2 weeks
2-4 weeks
1-3 months
3-6 months
6 months - 1 year
Too long! (more than 1 year)
No elements found. Consider changing the search query.
List is empty.

Primary Reason for Wanting to Speak w/ a PT *

I'm not sure if Physical Therapy is right for me, and talking to a PT will help me decide
I'd like to know the Root Cause of my pain or issue if you can help me fix it
I'm in a lot of pain and I'd like to know if you can help me
I have issues with my balance and mobility and want to know if Physical Therapy can help me
No elements found. Consider changing the search query.
List is empty.

Main Goal of Physical Therapy *

Find out what's wrong
Stay healthy and get fixed BEFORE the pain gets worse
Treat Root Cause of Pain
Increase Activity Level
Ease Pain & Stiffness
Improve Balance & Mobility
Avoid Reliance on Pain Medications
Avoid Injections or Surgery
Return to a Sport or to Work
No elements found. Consider changing the search query.
List is empty.

By checking this box, I consent to receive text messages from Gordon Physical Therapy at my provided phone number. I understand that message/data rates may apply and that I can opt-out at any time by replying STOP.