Please tell us...
Please Enter Your Name
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First Name
Last Name
Which Service Do You Need?
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Physical Therapy
Preparation for Birth
Postpartum Health
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Where Do You Feel the Discomfort?
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Please select one
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Pelvic Muscle (Down there)
Due to Pregnancy
Due to Postpartum
Hip
Knee
Shoulder/Neck
Sports or Exercise Injury
Foot/Ankle
Wrist/Hand
Elbow
Not Sure Where It's Coming From
How Long Have You Suffered Or Worried?
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A Few Days
1-2 Weeks
2-4 Weeks
1-3 Months
Long Enough
Too Long (Years)
What Is Concerning You The Most
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What Does It STOP You From Doing?
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The Main Goal You Would Like Us To Help Achieve For You
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Please select one
Ease pain
Ease stiffness
Stay active or involved in sporting activity
Find out what's wrong
Avoid Worsening Pain
Prepare for Childbirth
Postpartum Healing
Return to Active Lifestyle
What do you value most when making your decision to choose a Physical Therapist? (check all that apply)
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Natural Treatments
Hands on care (example: massage, manual therapy, etc.)
One-on-one care
Home Exercises To Speed Up Your Recovery
Other
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So we can get in touch with you about the cost and availability of the service you have requested, please leave us:
Best Phone Number
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Best E-mail
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