Online Consultation

Please Fill Out This Short Questionnaire Below Prior To Your Appointment So That Your Therapist Has All Of Your Details

Full Name*
First Last
Email Address:*
Phone Number:*
Date of Birth:*
DD slash MM slash YYYY
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Describe Your Problem That You Are Looking For Help With :*
What Is It Stopping You From Doing?*
Please be as specific as possible. What movements in everyday life are uncomfortable?
How Long Has It Been Going On For?*
Do You Have Any Other Past Medical History (Allergie or Underlying Conditions)?*
Do You Have Any Other Past Medical History (Allergies or Underlying Conditions)?*
Do you have or had any of the following? Bladder dysfunction? History of cancer? immunosuppression? Night pain? History of recent trauma? Loss of sensation to the area of the buttocks, perineum and inner surfaces of the thighs? Lower extremity neurological deficit (numbness or inability to use limbs)?
Have You Had Any Injuries In The Past (even sprained ankles, surgeries etc)?*
Are There Any Activities or Movements That Are Particularly Important To You?*
Have You Ever Attended Any Form Of Therapy Before (Physio, Chiropractors, Sports Therapists etc)?*
Consent*
By ticking this box I consent to the general T+Cs and specifically consent to undertake online assessment and treatment guided by a physiotherapist or sports therapist with O'Neill Physiotherapy.
Signature*

F.A.Qs:

What Equipment Do I Need?

All you need is a device with a webcam and microphone so that you can connect over video call. You will also need to be connected to the internet.

Will I Need To Do Anything On The Call?

You may be asked to stand up and perform certain movements, and you may be coached through some exercises, so wear suitable clothing (e.g. shorts or tracksuits)

Do I Need To Download Anything For The Call?

You will be sent a link to join the call prior to your appointment. We advise you click that as soon as it arrives and download any relevant software to avoid delays