First Name
Primary Reason For Wanting a Discovery Session
I'm new to therapy and not sure what to expect.
I was let down in the past by other therapies and would like to see and meet with the specialist before I commit.
I am NOT sure if therapy can even help me with my condition
It's just easier for me doing it this way.
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Where does it hurt?
Shoulder/Neck
Elbow
Wrist/Hand
Back
Knees/Legs
Muscle Injury from Sport/Exercise
Not Sure Where It's Coming From
I have Neurological Problems
Other
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What does it stop you from doing?
What Concerns You Most?
The Pain Getting Worste
Difficulty Moving
Not Being Able To Be Active
Not Being Able To Sleep Well
Avoiding Pills
Avoid Injections/Surgery
I Had Surgery and I'm Concerned About My Recovery
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What Is Your Main Goal You Would Like us to Help You Achieve?
Ease Pain
Ease Stiffness
Get Active
Stay Active
Avoid Dependency On Pills
Avoid Surgery
Find Out What's Wrong
Stay Healthy And Get Fixed BEFORE Pain Gets Worst
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How Long Have You Suffered?
Haven't—This Is Prevention (Not Cure)
A Few Days
1-2 Weeks
2-4 Weeks
1-3 Months
Long Enough
Seems Like Too Long (Years)
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No1 Thing Would Like To Achieve
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