The fastest way to schedule an appointment is to submit the online request form below and include the following information:

• Your address
• Date of birth
• Name of your insurance, identification number and group number (if one is listed)
• Who is the subscriber to your insurance? I need their name, date of birth and the name of their employer
• What days and times generally work best for you to schedule an appointment?
• How did you find me? Did someone refer you to me?
• Brief explanation for this therapy request

Once I receive this information I will verify your benefits to let you know if you have a deductible, copay or coinsurance. I will also send you some available dates to schedule.

If you have questions or require additional information other than scheduling an appointment please complete the form below and state the reason on the request.

***Please note that if you submit an online request you will NOT receive a phone call. Your request will be carried out via email format with an email response provided within 72 hours. If you do not receive a response within 72 hours please check your SPAM or contact the office again***

3154 Suite 100 Memorial Highway
Dallas, Pa 18612
(Located in the Fieldhouse Sporting Goods building)