What is your neurological diagnosis or injury?
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Please be as specific as possible.
What are your top 1-2 recovery goals right now?
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(Example: stand with assistance, improve transfers, increase core strength, walk with a device, gain more independence, etc.)
What are you hoping to get out of a recovery program like this — physically, mentally, or emotionally?
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(Tell us what success would look like for you. We want to know what matters most to you.)
Which program length are you interested in?
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2 weeks
3 weeks
4 weeks
5 weeks
6 weeks
7 weeks
8 weeks
Open to recommendation
When would you be interested in starting the program?
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When would you be interested in starting the program?
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ASAP - Summer 2025 (June or July start)
August 2025
September 2025
October 2025
November 2025
December 2025
Not sure - would like more information first
Whenever there is availability - my schedule is flexible
I'm not interested
Which clinic would you be interested in doing your intensive at?
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Spero Rehab in Katy, Texas
Spero Rehab in Austin, Texas
Either location works for me
Spero PT (if applicable)
Spero OT (if applicable)
Clinician Input (if applicable)
Where would you be traveling from? (City, State)
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Client's Name
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First Name
Last Name
Client / Contact Person's Email
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example@example.com
Client / Contact Person's Email
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Please enter a valid phone number.
Format: (000) 000-0000.
What else do you would you like us to know or consider?
Please check the box indicating how you would like to receive communication from Spero Rehab:
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By clicking this box, you agree to receive SMS messages from Spero Rehab. You can reply Stop to opt-out at any time, reply Help for assistance. Messages and data rates may apply. Message frequency will vary.
I DO NOT consent to receive SMS messages from Spero Rehab, including about my appointments or plan of care. I prefer to be contacted via phone call and/or email only.
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