OTZ Patient Contact Form

Please submit the form below to contact us for more information about your OTZ diagnosis and treatment options.

Sponsor Your Chiropractor
If you'd like to sponsor your chiropractor to receive training while you receive initial treatment at the OTZ clinic in Dallas, Texas, please also include your doctor's contact information.

Your name*

First Name

Last Name

Your email*

Your phone number*

Your address*

City

State

Zip Code

Country

How long have you had Frozen Shoulder Syndrome (FSS)?*

Number of months

In which shoulder(s) does the condition exist?*

Questions or comments

Receive The Latest Research & Developments Yes No

Keep me informed, but not too often!

Would you like us to contact your doctor? Yes
No

OTZ can answer all questions about the treatment and training options.

	Please submit the form below to contact us for more information about your OTZ diagnosis and treatment options. Sponsor Your Chiropractor If you'd like to sponsor your chiropractor to receive training while you receive initial treatment at the OTZ clinic in Dallas, Texas, please also include your doctor's contact information.
	Your name* First Name Last Name
	Your email*
	Your phone number*
	Your address* City State Zip Code Country
	How long have you had Frozen Shoulder Syndrome (FSS)?* Number of months
	In which shoulder(s) does the condition exist?*
	Questions or comments
	Receive The Latest Research & Developments Yes No Keep me informed, but not too often!
	Would you like us to contact your doctor? Yes No OTZ can answer all questions about the treatment and training options.

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