Physical Therapy Clinic | CA | ReVITALize Rehab Club
Schedule Appointment
Telehealth Inquiry
Arrange Your Free (15 Minutes) Tele-Health Interview With A Holistic Orthopedic + Sports Medicine Specialist
Step 1 of 3 – About You
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Please Enter Your First Name
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First
Primary Reason For Wanting To Sample Physical Therapy
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I’m new to Physical Therapy and not sure what to expect
I’ve had Physical Therapy but first time thru Telehealth
I’m NOT sure if Physical Therapy or doing it virtually can help me so I need to know the process more
I’d like to get a feel for what and How telehealth can help me BEFORE I commit to a full appointment
Where Does It Hurt?
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Please Select One
Lower Back
Knee
Shoulder
Neck
Foot/Ankle
Muscle Injury from Sport/Exercise
Not Sure Where It's Coming From
What Does It STOP You From Doing?
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What is your expectations from your virtual session?
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How Long Have You Suffered Or Worried?
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A Few Days
1-2 Weeks
2-4 Weeks
1-3 Months
Long Enough
Too Long (Years)
The Main Goal You Would Like Us To Help Achieve For You
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Please Select One
Ease Pain
Ease Stiffness
Get Active
Stay Active
Avoid Painkillers Dependency
Find Out What's Wrong
Stay Health and Get Fixed BEFORE Pain Gets Worse
Phone Number
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Please tell us where to contact you with the outcome of the Free Taster Session application:
Best Email
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