New Contact Submission Form

Use this form to add new contacts into our system and ensure they are placed in the appropriate email campaign based on their interest or interaction (ebook download, newsletter signup, appointment, etc.).

If the individual has scheduled a visit (workshop, discovery visit, or treatment session), please also include the date and time of their appointment.

For general entries such as ebook downloads or newsletter signups, you can leave the appointment section blank.

This form helps us automate communication, send reminders, and ensure each person receives the right follow-up based on their needs.

Contact Us

Mile High Physical Therapy & Balance Center

495 Uinta Way, Suite 110
Denver, CO 80230

Phone: (303) 856-3299

Fax: (303) 856-7787

info@milehighpt.com

Individualized One-on-One Care for Optimal Results