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Total Body Diagnostic

So That We Can Serve Your SPECIFIC Needs, Please Fill Out This 30 Seconds Form And 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 To Speak With A Specialist *

I'm new to physical therapy and am not sure what to expect

I was let down by another healthcare provider in the past & would like to see how good you are before I commit

I'm not sure if physical therapy can even help me

I'd like to get a feel for what you can do to help me BEFORE I commit to a full appointment

I am already doing some exercises but I need guidance

Where Does It Hurt? *

What Does It Stop You From Doing? *

What Concerns You The Most That Makes You Want To Consider Physical Therapy? *

The Pain You Are Experiencing
Not Knowing What's Wrong
Want To Avoid Painkillers & Medications
Fear Of Not Being Able To Stay Active
The Risk Of Needing Dangerous Surgery
Concern Of No Sign Of Improvement
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How Long Have You Suffered or Worried? *

Haven't - This is Prevention

A Few Days

1-2 Weeks

2-4 Weeks

1-3 Months

Long Enough (4+ Months)

Seems Like Too Long (Years)

What Would Be The #1 Thing You Would Like Us To Achieve For You? *

Phone *

Email *

What Other People Just Like You Are Saying About Effective Physical Therapy...

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Company

Open Hours

Monday - Friday: 7:30AM - 6PM

Location

2324 So. Congress Ave., Suite 1A, Palm Springs, FL 33406

2324 S Congress Ave suite 1a, West Palm Beach, FL 33406, USA

Medical Disclaimer

All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.

+1 (561) 867-7641

fernando@effectivept.com

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+1 561-408-0903

fernando@effectivept.com

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