Please tell us...
Please Enter Your First Name
Please Enter Your Kid's Name (if requesting on behalf of a child)
Primary Reason For Wanting To Sample Physical Therapy
I'm new to physical therapy and am not sure what to expect
I was let down by another physical therapist in the past and would like to see how good you are before I commit
I'm not sure if physical therapy can even help me
I'd like to get a feel for what you can do to help me BEFORE I commit to a full appointment
It's just easier for me doing it this way
What problem are you seeking help for?
Please select one
Pain in joint or other body tissue
Urgency or Frequency
Issues related to sexual intercourse
What Does It STOP You From Doing?
How Long Have You Suffered Or Worried?
A Few Days
Too Long (Years)
What would be the one thing you would like us to achieve for you?
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
So we can arrange this Complimentary Discovery Visit for you, please tell us:
Best Phone Number
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