Free TMJ Screening Sign-Up

8118 Dental Professionals

Thursday 2/22, 9am - 12pm

Receive a free TMJ screening from Physical Therapist, Dr. Gonzales- the owner and founder of Mind Body Physiotherapy.

Don't let pain hold you back, we can help! Our goal is to find the root cause of your pain instead of just treating symptoms so that you can learn how to be pain-free.

Full Name *

Phone *

Email *

What are your current concerns? Are you experiencing pain or other symptoms? *

Mind Body Physiotherapy has my permission to use my photograph and/or video publicly to promote their businesses. I understand the images and/or video may be used in print publications, online publications, presentations, websites and social media. I also understand that no royalty fee or other compensation shall become payable to me by reason of such use. *

I have read and consent to the photo/video release policy

I do NOT want my photo or video to be used

I understand that this screening is for educational purposes and not intended to treat or diagnose any musculoskeletal conditions. Participation does not guarantee injury prevention. I desire to engage voluntarily in the screening. By selecting “I understand” I completely and unconditionally release all liability to Mind Body Physiotherapy. *

I understand