What is your ideal day for an appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
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Will you be using insurance or paying cash?*
I'll be using insurance
Paying cash
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Where is your pain or stiffness?*
Back
Neck
Shoulder
Arm
Hand
Hips
Leg
Knee
Ankle
Foot
Other
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What is your main concern?*
Not knowing what's wrong
The pain you're experiencing
Concern at no sign of improvement
Loss of independence and mobility
Relying on painkillers
Not being able to work
Fear of surgery
Concern over future health issues
Other
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A few days
1-2 weeks
2-4 weeks
1-3 months
Long enough
Seems like years (too long)
Your main goal that you'd like us to help you achieve:*
Ease pain
Ease stiffness
Get active
Stay active
Avoid painkillers
Avoid surgery
Rehabilitation
Stay healthy and get fixed before it gets worse!
Find out what's going on
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