Request Appointment Your Forms Submission Limit is Over. Contact Us Whether you have a question for a therapist, an insurance or pricing question for our billing department or would like to request an appointment, please fill out the form below and we will get back to you as soon as possible. We can often schedule new patients within 24 hours. We invite you to Experience the Difference an independent clinic can make in your recovery! First and Last Name : * Email : * Phone (with Area Code) : * Characters Left Best Time(s) and Day(s) to contact you : * Characters Left How Can We Help You? : * Character(s) left Location Preferred : * Lititz Office Lancaster West Office Lancaster East Office Ephrata Office How Did you hear about us? : * Doctor Newspaper Website Community Event Social Media Family or Friends Other (explain) If other, please explain : * Characters Left By checking this box you agree to receive email communication from HARTZ Physical Therapy (can unsubscribe at any time) : * By using this form you agree with the storage and handling of your data by this website *
