• About
  • Get Your Score
  • Conditions
    • Urinary Incontinence
    • Urinary Urgency and Frequency
    • Bowel Problems
    • Prolapse
    • Pelvic Pain
    • Pregnancy
  • Contact Brittney
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  • Join Now
  • Consultation Forms
  • About
  • Get Your Score
  • Conditions
    • Urinary Incontinence
    • Urinary Urgency and Frequency
    • Bowel Problems
    • Prolapse
    • Pelvic Pain
    • Pregnancy
  • Contact Brittney
  • Login
  • Join Now
  • Consultation Forms
BOOK A CONSULTATION
My Core Floor 1:1 Consultation
1 hour consultation, Movement assessment, Video of a Personalized Home Exercise Program.
Follow Up Visits: $75 - $150
Contact Brittney
BOOK A CONSULTATION

SYMPTOMS

What are the symptoms you hope to be addressed with pelvic floor PT?
Click all the apply.
How long have you been dealing with these symptoms?
Additional Comments:

OTHER CONDITIONS/ SURGERIES

Do you have any joint pain, back pain, or other orthopedic type symptoms that you deal with on a regular basis? Click all that apply.
Have you had any surgeries - related or unrelated to the problems you are coming for today?
Additional Comments:

PREGNANCY

Have you been pregnant and/or delivered a child in the last 12 months?
Have you been pregnant and/or delivered a child more than 12 months ago?
Additional Comments :

BLADDER / BOWEL

Do you ever leak urine with coughing, laughing, sneezing, squatting or with exercise?
Do you ever leak urine trying to get to the bathroom?
If you suffer with incontinence do you wear a pad or special underwear?
If you suffer with incontinence do you ever have to change your clothes because of leaking/accidents?
Do you have a strong sense of urgency when you have to urinate?
Do you go to the bathroom more often than every 3 hours?
Do you get up more than 1x per night to go to the bathroom?
Do you have difficulty holding back gas?
Do you ever feel you may “leak” stool or have difficulty making it to the bathroom for a bowel movement?
Additional Comments :

PROLAPSE

Have you ever been diagnosed with a vaginal prolapse, experienced vaginal pressure or have had a feeling the something is "falling out" of your vaginal opening?
Additional Comments :

PAIN

Do you have general pelvic type pain (including vaginal pain, abdominal pain, hip/groin pain) during the day related to specific activities you do or clothes you wear?
Do you have pain with intercourse or avoid intercourse for fear of pain?
Is your quality of life impacted by urinary or pelvic pain issues?
Do you have pain with using a tampon, or with GYN exams?
Additional Comments :

ACTIVITY

Do you sit for more than 50% of your day?
Do you exercise 3 or more days/week?
Additional Comments :

Consent for Treatment

Telehealth technology allows healthcare providers to examine the patient with interactive videoconferences. Healthcare professionals, and specialists can remotely provide necessary services with this technology.


Purpose:

The purpose of a Telehealth Consultation Consent Form is to obtain the client's consent to participate in this telehealth consultation.

Confidentiality:

Voice and video from the client will not be recorded. The medical condition and history of the client will be kept confidential and can be used for future research.

Client Rights:

The client can withhold or withdraw the telehealth consent at any time and this will not affect future sessions. The client can ask questions regarding the consent, telehealth services and procedures for clarification.

Risks & Benefits:

The client has been informed about the potential risks and benefits of the telehealth service. He/she has understood that he/she can make a complaint about the telehealth services by notifying the assessor.

Services:

Professionals will schedule and conduct the treatment process. Clients accept to pay one-time consent for healthcare services the fee that has been agreed upon.

Consent for Treatment Form

Electronic Signature
Clear
Undo

Brittney will contact you back via email to schedule your initial consultation.

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© 2023 My Core Floor. All Rights Reserved.
© 2023 My Core Floor. All Rights Reserved.
Brittney Cappiello

Brittney Cappiello
MSPT, FAFS

Contact Brittney

About Brittney

In the grocery store and on the street, strangers are compelled to talk to me. My coworkers joke that I must wear a sign that says “talk to me and tell me your story”. I’m not sure how I give off that vibe, but I wouldn’t trade it for anything. It’s what has allowed me to connect so well with my physical therapy patients over the course of my career. I truly enjoy making lasting personal connections, earning their trust, and establishing a comfort level for the women I treat. This bond becomes an opportunity for vulnerability, which is never easy, but it is when the sharing of honest information occurs. I have discovered that this crucial personal information is often not revealed in other aspects of medical care. The interaction with my patients is a relationship that I take seriously and enjoy tremendously. My so called “people person superpower” is what drove me to create My Core Floor. It’s an opportunity to connect with women outside of my physical therapy clinic. It’s a resource to spread accurate, understandable content and not let myths and misinformation dictate how we live. It’s a chance to create a program that will make women stronger. I look forward to helping you and hearing your story.

Personally, I would like to thank my family for their loving support, my coworkers for their constant encouragement, Bob Wiersma for sharing his creative insights, and Gary Gray of the Gray Institute for influencing my treatment style. You have all helped solidify my passion for improving the lives of women and I am forever grateful.

Ask Brittney Cappiello
Brittney Cappiello

Brittney Cappiello
MSPT, FAFS

Contact Brittney

About Brittney

In the grocery store and on the street, strangers are compelled to talk to me. My coworkers joke that I must wear a sign that says “talk to me and tell me your story”. I’m not sure how I give off that vibe, but I wouldn’t trade it for anything. It’s what has allowed me to connect so well with my physical therapy patients over the course of my career. I truly enjoy making lasting personal connections, earning their trust, and establishing a comfort level for the women I treat. This bond becomes an opportunity for vulnerability, which is never easy, but it is when the sharing of honest information occurs. I have discovered that this crucial personal information is often not revealed in other aspects of medical care. The interaction with my patients is a relationship that I take seriously and enjoy tremendously. My so called “people person superpower” is what drove me to create My Core Floor. It’s an opportunity to connect with women outside of my physical therapy clinic. It’s a resource to spread accurate, understandable content and not let myths and misinformation dictate how we live. It’s a chance to create a program that will make women stronger. I look forward to helping you and hearing your story.

Personally, I would like to thank my family for their loving support, my coworkers for their constant encouragement, Bob Wiersma for sharing his creative insights, and Gary Gray of the Gray Institute for influencing my treatment style. You have all helped solidify my passion for improving the lives of women and I am forever grateful.

 

COMING SOON

My Core Floor 1:1 Consultation

1 hour consultation, Movement assessment, Video of a Personalized Home Exercise Program.

Follow Up Visits: $75 - $150

Contact Brittney

Brittney will contact you back via email to schedule your initial consultation.

Ask Brittney Cappiello
My Core Floor 1:1 Consultation

1 hour consultation, Movement assessment, Video of a Personalized Home Exercise Program.

Follow Up Visits: $75 - $150

Contact Brittney

Brittney will contact you back via email to schedule your initial consultation.

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