First Name *

Primary reason for wanting to start with a Discovery Visit *

I'm new to PT and not sure what to expect

I'm not sure PT can help me

I've been let down by other PT's and would like to see how good you are before I commit

I would like to get a feel for how you can help me BEFORE I commit to a full appointment

It is just easier for me to do it this way

Where Is Your Pain Or Stiffness *

• Low Back
• Neck
• Jaw
• Shoulder
• Arm
• Hip
• Knee
• Ankle
• Foot
• Muscle Injury from Sports or Exercise
• Not Sure Where It's Coming From
• No elements found. Consider changing the search query.
• List is empty.

What does it STOP you from doing *

What concerns you most *

• Not knowing what's wrong
• Depending upon painkillers
• Losing mobility or independence
• The risk of facing dangerous surgery
• No elements found. Consider changing the search query.
• List is empty.

How Long Have You Suffered Or Worried *

• A Few Days
• 1-2 Weeks
• 2-4 Weeks
• 1-3 Months
• Long Enough
• Too Long (Years)
• No elements found. Consider changing the search query.
• List is empty.

Main Goal *

• Ease pain
• Ease Stiffness
• Get Active
• Stay Active
• Avoid pain pills
• Find out what is wrong
• Stay healthy and get fixed before the pain gets worse
• No elements found. Consider changing the search query.
• List is empty.

Phone *

Email *

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