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Balance Therapy

Balance Therapy

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The Balance Home Test

Watch the video above, then use the form below to send your Home Balance Test Results directly to our team! We’ll use the information you provide to contact you to schedule your Balance Consultation. If you have any questions, please call our office!

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Home balance test form

Step 1: 2 Feet on the Floor

Place both feet on the floor, shoulder width apart, with your arms at your sides

1A. Eyes Open (required)

Did you pass or fail?

1A Eyes open result

Step 2: 1-Leg Balance Test, Eyes Open

1 foot on the floor, one leg bent at 90 degrees

2A. Right Leg Up, Eyes Open (required)

Did you pass or fail?

2B. Left Leg Up, Eyes Open (required)

Did you pass or fail?

3A. Right Leg Up, Eyes Closed (required)

Did you pass or fail?

3B. Left Leg Up, Eyes Closed (required)

Did you pass or fail?

Submit your results using the button below, and we’ll contact you to schedule your Balance Consultation!

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