Can Physical Therapy Help Me?

Are you still unsure if physical therapy is right for you? Perhaps we can help. Please provide as much detail as possible regarding your condition so that we can give you the best advice. (Please allow up to one week for response.)

Patient name

E-mail Address

Diagnosis/Description of Condition

Duration of Symptoms

Severity of Pain (minimal, moderate, severe)

Personal Goal (What do you expect from treatment?)

Current Treatment (What are you currently doing for the problem?)

Test Results (X-ray, MRI, CT scan, etc.)

Related Medical Conditions (diabetes, heart disease, etc.)