Apply For A Discovery Visit
Please Enter Your First Name
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Primary Reason For Wanting To Speak With A Specialist*
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I'm new to Chiropractic and am not sure what to expect
I was let down by another Chiropractic in the past and would like to see how good you are before I commit
I'm not sure if Chiropractic 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
It's just easier for me doing it this way
Where Does It Hurt?
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Back
Knee
Shoulder/Neck
Sports or Exercise injury
Foot/Ankle
Wrist/Hand
Elbow
Not sure where it's coming from
What Does It STOP You From Doing?
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What's Your Main Concern That Has You Considering Chiropractic?*
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The pain you are experiencing
Fear of not being able to keep active/involved in sporting activity
Worry about not knowing what's wrong
Want to avoid painkillers
Concern at no signs of improvement
Future ill health (and wanting to prevent it)
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)
What would be the one thing you would like us to achieve for you?*
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Ease pain
Ease stiffness
Stay active or involved in sporting activity
Avoid painkiller dependency
Find out what's wrong
Stay healthy and get better before the pain gets worse
So we can arrange this Complimentary Telephone Consultation for you, please tell us:
Best Phone Number
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Best E-mail
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