Physical Analysis Questionnaire
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727-223-9902
HOME
ABOUT US
CAREERS
Physical Therapy
SERVICES
Main Services
Physical Therapy
Exercise & Stretches
Additional Equipment
Therapeutic Equipement
Neubie
Ultrasound
Laser
Electric Stimulation
Equipement
Novothor
Cold Plunge
Oxygen
Saltroom
Sauna Treatments
CONTACT US
Home
Physical Therapy
Services
About
Careers
Contact us
close
727-223-9902
Take the First Step Towards a Pain-Free, Active Life
Answer these simple questions so we can analyze your physical condition and get you on the right track to full recovery.
Physical Therapy
What is the current issue with your body?
On a scale of 1-10, what level of pain are you experiencing?
What are your goals for Physical Therapy?
What are your goals for Physical Therapy?
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How active are you on a day-to-day basis?
How often do you exercise?
How often do you stretch?
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7. Is your body issue or pain affecting your sleep?
Yes
No
8. Is your body issue or pain affecting your regular daily activities?
Yes
No
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Full Name
Email
Phone Number
Any additional information
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