Primary Reason You Want To Speak With A Physical Therapist * I'm in pain and want to create a plan to start getting better ASAPI'd like to know what's wrong and how long it will likely take to fixI think Physical Therapy might help my injury/pain but I'd like speak with a Therapist to be sureOther - not listed above * Where Is Your Pain Or Stiffness? Lower BackMid/Upper BackNeckShoulderElbowWrist/HandHipKneeAnkle/FootMultiple body parts/areasMuscle injury not listed aboveNot sure where it's coming fromOther - not listed above * What Does It Stop Or Limit You From Doing? * What Concerns You Most About Your Pain/Injury? Not knowing what's wrong and what's causing the painHaving to take painkillers to ease the painBeing limited in how much you can exercise / play your sport / stay activeLosing mobility or independenceThe risk of facing surgeryOther - not listed above * How Long Have You Suffered Or Worried? 1-2 Weeks (or less)2-4 Weeks1-3 Months4-12 MonthsOver A Year * Your First Name * Best Time For Your Phone Consultation? MorningMid-DayAfternoon * Phone Number * Best Email * * mandatory fields
