Request an Appointment

Please choose the type of appointment you would like and complete the form below. We will get back to you promptly.

Please choose one

In-person Appointment

Telehealth

Free Injury Assessment

Name(Required)

First Last

Date of Birth(Required)

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Preferred Date(Required)

Preferred Time(Required)

Do you prefer to upload a photo of your insurance card or enter the information manually?

Upload

Enter Manually

Upload Insurance Card(Required)

Max. file size: 100 MB.

Insurance Company Name(Required)

Insurance Group #(Required)

Insurance ID #(Required)

What is the Best Time to Call You?

How did you hear about us?(Required)

Referring Provider?

Yes

Referring Provider's Name(Required)

Please briefly describe your concern(Required)

Is this urgent and are you requesting a same-day appointment?(Required)

Yes

Contact Information

Get in Touch

Optimal Physical Therapy - Lake Mills

805 Elm Street
Lake Mills, WI 53551

Optimal Physical Therapy - Marshall

Located at the Ranch Training Center
506 Plaza Drive
Marshall, WI 53559

Office Hours

Monday: 7 am – 7 pm
Tuesday: 7 am – 6 pm
Wednesday: 7 am – 7 pm
Thursday: 7 am – 6 pm
Friday: 7 am – 12 pm

Request Appointment

Request Appointment

Request an Appointment