Let’s Get to the Root Cause of Your Nerve Pain.

This quick 3–5 minute survey is designed to help us understand your symptoms and uncover the underlying cause of your discomfort. Your answers will guide our team in creating a personalized, non-invasive care plan focused on real, lasting relief.

Full Name *

How long have you been experiencing pain ? *

What would finding relief allow you to do again? *

What's your best email we can reach you? *

This offer is not covered by either Medicaid or private insurance. Do you agree to pay $47 out of pocket ? *

Phone *

Please note: If you do not provide a valid phone number, we will not be able to consider you for the program.

By providing your mobile phone number and checking this box, you consent to receive SMS text messages from Absolute Integrative Physical Medicine at 707-665-1919 related to appointments, billing, patient care, health information, office events, and promotional offers. Message frequency varies. Message and data rates may apply. Reply STOP to opt out at any time. Reply HELP for assistance. View our SMS Terms & Conditions and Privacy Policy.

I understand that the clinic is located in Vacaville, California, and I am willing and able to commute there. *

Yes