First Name
*
Primary reason for wanting to sample Physical Therapy
*
What does it stop you from doing?
*
What concerns you most that makes you want to sample physical therapy?
*
What concerns you most that makes you want to sample physical therapy?
Depending upon painkillers
I don't know what's wrong
Fear of losing mobility or independence
The risk of needing invasive surgery
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How Long Have Your Suffered Or Worried?
*
Haven't - this is prevention not cure
A Few Days
1-2 weeks
2-4 weeks
1-3 months
Long enough
Too Long (Years)
Please tell us how long you have suffered/worried *
What would be the one thing you would like us to achieve for you?
*
What would be the one thing you would like us to achieve for you?
Ease pain
Ease stiffness
Get active
Stay active
Avoid Painkiller Dependency
Find Out What's Wrong
Stay Healthy and Get Fixed Before It Gets Worse
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Phone
*
Email
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