REQUEST FREE PHONE CONSULT SCHEDULE YOUR FREE PHYSICAL THERAPY PHONE CONSULT A PT Phone Consult is a free 15-minute telephonic consultation with our expert Physical Therapist. During the call, you will be able to discuss any problems you may have with the therapist and she will be able to inform you whether Physical Therapy will benefit your condition or not. Additionally, she may suggest you simple tips/exercises to help ease your problem/pain. In order to make sure your phone consult with the Physical Therapist is efficient and individualized please fill out the simple form below: Main Reason for Requesting a Physical Therapy Discovery Visit?* (Please select all that apply) I am new to Physical Therapy and not sure what to expect.I have been advised by my doctor to do pulmonary rehabilitationI have been advised by my doctor to do cardiac rehabilitationI am not sure if Physical Therapy can even help me with my problem/pain.I have had Physical Therapy in the past and would like to see if we are a good fit for each otherI want to understand what’s causing my problem/pain and what the Physical Therapist can do to help me before I commit to a full appointment.It is easier this way to make an informed decision to get started.Other What Is Your Current Problem For Which You Are Seeking Physical Therapy?* (Please select all that apply) I have pain/stiffness/muscle weakness/tingling/ numbness (further drop down as below when this selected) BackNeckKneeAnkleHipShoulderelbowHand/wristMuscle injuryMultiple body partsOther not listed above I have difficulty breathing /clearing my phlegm I have repeated chest infection or repeated hospitalization due to chronic lung diseaseI suffer from chronic lung disease eg. COPD, Cystic fibrosis etc.I have suffered from a heart attack/heart failure or had a heart surgery and am afraid to exerciseI have poor balance/had a fall and want to prevent falls I am dizzy and would like to inquire about vestibular rehabilitation I have problems with urinary incontinence I am an athlete who is injured Other What Does It Stop/Limit You From Doing?* What Concerns You The Most About Your Problem That Is Making You Consider Physical Therapy?* (Please select all that apply ) I don’t know what is causing my pain/ problem and how to deal with itDependence on pain medicationGetting short of breath with minimal exertionResuming activity/ exercise after cardiac problemsInability to enjoy leisure activities and maintain my quality of lifeLoss of my mobility and independenceBeing limited in how much I can exercise/stay active or play sportsUrine leakage with coughing, exercise or other strenuous activitiesLosing my balance and history of fallingRisk of possibly having to undergo surgeryOther The Main Goal That You Would Like To Achieve With Us?* (Please select all that apply) Ease my pain/problemImprove my mobility/balance and decrease risk of fallLead an active lifestyleReduce dependence on pain medicationImprove my quality to lifeReturn to enjoying my hobbies/recreational activities with friends and familyLearn to self-manage my problemReduce repeated hospitalization due to chronic heart and lung problemsReturn to prior athletic levelOther Next(Nearly Finished)>> Name:* Email Address: Phone number:* I am requesting a* (Please select one) In-person sessionTelehealth session Expect a phone call from 858 255 7976 in the next 24 hours (M-F)!
