*What Service Do You Need? What Option Best Describes You?
1. Physical Therapy
2. Posture Assessment and/or Wellness
3. Women's Health Physical Therapy
*What Is Concerning You The Most? What Option Best Describes You?
1. The pain you are experiencing
2. Fear of not being able to keep active
3. Worry about not knowing what's wrong
4. Want to avoid painkillers
5. Concern at no signs of improvement
6. Future ill health (and wanting to prevent it)
7. Public embarrassment from incontinence
8. Difficulty with intimacy and/or conception
*What Does It STOP You From Doing?
*How Long Have You Suffered Or Worried? What Option Best Describes You?
1. A Few Days
2. 1-2 Weeks
3. 2-4 Weeks
4. 1-3 Months
5. Long Enough
6. Too Long(Years)
*What do you value most when making your decision to choose a Physical Therapist? What Option Best Describes You?
1. Natural Treatments
2. Hands on care (ex. Myofascial Release, Manual Therapy, etc.)
3. One-on-one care
4. Home Exercises To Speed Up Your Recovery
5. Self-Treatment workshops
*What Would Be The One Thing You Would Like Us To Achieve For You? What Option Best Describes You?
1. Ease Pain
2. Ease Stiffiness
3. Stay active or involved in sporting activity
4. Avoid painkiller dependency
5. Find out what's wrong
6. Get better before the pain gets worse
7. Improve intimacy and/or ability to conceive
8. Improve bladder control
*Best Day and Time to Call
Submit
