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This quick quiz will help determine if chiropractic care is the right solution for you or if you need more guidance on improving your posture and spinal health. Please fill in your information below and click Next.

Full Name

Email *

Phone *

Do you experience back pain that interferes with your daily activities? *

Yes

No

How often do you experience neck stiffness or discomfort? *

Rarely

Occasionally

Frequently

Constantly

Do you spend more than 4 hours a day sitting at a desk or in front of a screen? *

Yes

No

Have you noticed uneven shoulders or hips when standing? *

Yes

No

How often do you feel tension or tightness in your upper back or shoulders? *

Rarely

Occasionally

Frequently

Constantly

Do you feel pain or numbness radiating down your arms or legs? *

Yes

No

Have you had difficulty sleeping due to back or neck pain? *

Yes

No

Which activity/activities aggravates your back pain the most? *

Sitting

Standing

Walking

Lifting Heavy Objects

Do you experience frequent headaches or migraines that could be related to neck tension? *

Yes

No

When was the last time you had your posture evaluated by a professional? *

Never

Over a Year Ago

Within the Last Year

Recently

Captcha

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