Arrange You Free (15 min) Free Phone Consultation With Our Specialist – 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! step 1 step 2 step 3 First Name * Last Name * Primary Reason For Wanting To Speak To A Specialist * Please select oneI’m in a lot of pain and want some tips/advice on what to do right away.I’m not exactly sure what is going on or how long it will take to get better.I’m not sure therapy is right for me and talking with a therapist would help me decide. Where Does It Hurt? * Please select oneShoulder/NeckElbowWrist/HandBackKnees/LegsMuscle Injury From Sport/ExerciseNot Sure Where It’s Coming FromI Have Numbness What Does It STOP You From Doing? * What Concerns You Most? * Please select onethe pain getting worstdifficulty movingnot being able to be activenot being able to sleepavoiding pillsavoiding injections/surgeryI had surgery and concerned about my recovery next step > step 1 step 2 step 3 How Long Have You Suffered? * Haven’t – this is prevention not cure A few days 1-2 weeks 2-4 weeks 1-3 months Long enough Seems like too long (years) What Is Your Main Goal You Would Like us to Help Achieve For You * Please select oneease painease stiffnessget activestay activeavoid dependency on pillsavoid surgeryfind out what’s wrongstay healthy and get fixed BEFORE pain gets worst Other Concerns (Specific) next step > So That We Can Arrange This Complimentary Phone Consultation For You, Please Tell Us… step 1 step 2 step 3 Email * Phone number * Submit
