First Name
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Last Name
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Email
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Please click the one that best describes you
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Active Adult
Eliminating Pain
Maintaining Independence
Road Runner
Trail Runner
Marathoner/Ultramarathoner
Recreational Runner
Triathlete
Ironman Athlete
Swimmer
Mountain Biker
Cyclist (Road/Track)
Adventure Racer (Spartan, Race, Hyrox, etc)
Aquabiker
Aquarunner
Other...
Have you already been seeking solutions to your issue or have tried other things prior to finding us?
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Yes
No
If you answered to the above, what have you already tried?
Traditional Physical Therapy (insurance based)
Chiropractic
Acupuncture/Dry Needling
I have no idea what I am doing
I wish I knew more so I can do it more often
I am inconsistent with it because of my schedule
If you answered to the above, what have you already tried?
Traditional Physical Therapy (Insurance Based)
Chiropractic Care
Acupuncture/Dry Needling
Massage/Stretch Therapy
Injections (steroid, PRP, trigger point, stem cell, etc)
Medications (OTC or Rx)
Surgery
Other...
What specific questions or topics are you looking to have answered during this call? We like to be as prepared and quickly able to assist as possible. Any information provided will be vital in assisting us in helping you.
Indicate an Ideal Time (We are open from 8am to 8pm - except Saturday)
8.00am
9.00am
10.00am
11.00am
12.00pm
1.00pm
2.00pm
3.00pm
4.00pm
5.00pm
6.00pm
7.00pm
8.00pm
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