Total Lowback Care would like to offer you a free screening.  A free screening gives you the opportunity to meet the doctors and staff at TLC with no obligation to you or out of pocket expense.   You will receive some tests and x-rays (if necessary) and discuss your case with a qualified physician.  You will be given an honest evaluation and recommendation.  To receive this free screening, simply fill out this online form and a Total Lowback Care staff member will contact you at a time that is convenient for you.  You may also call 1-800-LOWBACK to speak to the office directly.

Online Appointment Request Form


Your Name:

Phone Number:

Email Address:

How did your injury occur?:

Work Injury
Auto Accident
Surgery
Unknown/Unsure

Preferred Location:

Preferred Time (10:00am to 4:00pm):

When is the best time to contact you?