Which describes your situation best? *

I have NOT been suffering that long

I've been suffering for weeks

I've been suffering for months

Too long at this point. It's been years.

What's your name? *

What's your best email address? *

[email protected]

What's your phone number? *

I understand I'll be contacted regarding this application with a phone call or text message from TPR. I also understand that I can opt-out of messages at any time.

Where does it bother you the most? *

Back

Knee

Hip

Ankle

Neck/Shoulder

Other

What is your main concern when it comes to your pain? *

Don't want to lose my freedom or independence

Avoiding a surgery

Letting pain take over my life

Taking long-term medications

Which fits you best? *

I view spending on my health as an investment

I view spending on my health as an expense

If you're accepted to work with our specialized doctors of physical therapy, how soon can you get started? *

ASAP

Within 30 days

>30 days

Is there anything else we should know before the call? *

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