Infusionsoft Tags
Nurture Subscriber
New Lead
New Customer
Interest - Email Series
Myself
Clean List
Email Typos
Newspaper
Google Adwords
Website
Facebook
New Patient Welcome -> Broadcast Land
Patient's Status -> Live Patient
Didn't book eval
Didn't go ahead with treatment
Booked treatment
Start Birthday Campaign
Booked Discovery
Back Pain Report Opt-In
Back Pain Ebook
Duplicate Contacts
Reports
Re
Rep
quiz
Happy Birthday Reminders
Birthday Club Member
Low back pain workshop
Shoulder pain
Direct Access
Direct Access-2
2020 Check in
Knee Pain Workshop 2/2020
LBP
Pop up-neck pain
Facebook-LBP
Previous patient
warm lead
Current patients
Leadpages-Webinar
Missed WFH webinar
Spamhaus Affected Jan 2021
Knee Pain
Discovery session
Past Patient
Past Patient Loop
Loop
Website Leads
Post First Appointment
Yahoo deliverability issues 2021
Diagnosis: Knee Pain
Telehealth PDF Download
Neck Pain
Telehealth PDF
TKR
neck pain
Hip Pain
LBP
Ankle/Foot Pain
Back Pain
Wrist/Hand Pain
Elbow Pain
Please tell us...
First Name
*
Last Name
*
Are you looking for a phone call or virtual discovery session via Zoom?
*
Please call me!
I would like to visit via Zoom.
Primary Reason For Wanting To Speak With A Specialist
*
I'm not sure if physical therapy can even help me
I'm new to physical therapy and am not sure what to expect
I'd like to get a feel for what you can do to help me BEFORE I commit to a full appointment
I was let down by another physical therapist in the past and would like to see how good you are before I commit
It's just easier for me doing it this way
Where Does It Hurt?
*
Please select one
Back
Knee
Shoulder/Neck
Sports or Exercise Injury
Foot/Ankle
Wrist/Hand
Elbow
Not Sure Where It's Coming From
What Does It STOP You From Doing?
*
Back
Next
What's Your Main Concern That Has You Considering Physical Therapy?
*
Please select one
The pain you are experiencing
Fear of not being able to keep active/involved in sporting activity
Worry about not knowing what's wrong
Want to avoid painkillers
Concern at no signs of improvement
Future ill health (and wanting to prevent it)
How Long Have You Suffered Or Worried?
*
A Few Days
1-2 Weeks
2-4 Weeks
1-3 Months
Long Enough
Too Long (Years)
What would be the one thing you would like us to achieve for you?
*
Ease pain
Ease stiffness
Stay active or involved in sporting activity
Avoid painkiller dependency
Find out what's wrong
Stay healthy and get better before the pain gets worse
Back
Next
So we can arrange this Complimentary Discovery Session, please tell us:
Best Phone Number
*
Best E-mail
*
Please verify that you are human
*
Click To Submit Your Inquiry >>
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