PT Consultation Questionnaire
Before you schedule, it is helpful for me to have a little more information so I know where to focus!
What is your main reason for scheduling a consultation with me?
I have never had Physical Therapy before and I am not sure what it is all about
I want to know if you would be a good fit for my therapist before I commit to scheduling anything
I have had a bad experience with PT in the past and am curious if you can help me in any way
I have a problem, but I am not sure if/how Physical Therapy can help
I am not sure I can afford Physical Therapy right now
What body areas are you experiencing pain/limitations in?
Tell me a little more about what type of problems you are having currently, if any?
What is your pain/discomfort currently stopping you or limiting you from doing?
How long has the pain been present?
Longer than 3 months
What is the main goal you would like to achieve in regards to your problem?
Get rid of my pain
Be able to move better and without pain
Improve my performance
What service are you most interested in learning more about?
Physical Therapy Evaluation and follow up visits
I just have a general question, not sure I need anything else
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