step form - discovery visit - Hands on Therapy

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Apply For A Free (30 min) Discovery Visit With Our Specialist

If you are unsure if Physical/Occupational Therapy is right for you OR if you have had “not so great experiences” before…this is a great opportunity to you to clarify if therapy is right for you.
So That We Can Meet Your SPECIFIC Needs, Please Fill Out This 30 sec Form & Show Us EXACTLY How You Want Us To Help You.
The more we know about you, the better we can help you!

First Name *

Last Name *

Primary Reason For Wanting a Discovery Session *

Where is your pain/problem area? *

What Does It STOP You From Doing? *

No 1 Thing Would Like To Achieve *

What Is Your Main Goal You Would Like us to Help Achieve For You *

Please Tell Us Where To Contact You With The Outcome Of The Free Discovery Visit Application

Best Email *

Best Phone *

Please check your email account in the next 10 minutes for a personal reply from Hands On Therapy Services

Call Now To Schedule An Appointment 786-615-9879