MM slash DD slash YYYY
Please check the percent improvement you experienced with treatment.
How soon were you able to make your first appointment?
Would you use us again?
Would you recommend us to a friend?
Receiving the Rakita Tomsic PT monthly newsletter on fitness, injury prevention, and physical therapy makes me more likely to use you in the future. (check the response that is most appropriate)
This field is for validation purposes and should be left unchanged.