What's Causing Your Pain?

Take this 60-second quiz to find out what could be triggering your back, neck, hip, or foot pain — and how to start feeling better naturally.

What areas do you feel pain or discomfort?

Neck/Shoulders

Lower Back

Feet/Ankles

Headache

Hips

Other

How long have you had this pain?

A few days

1-3 weeks

a dew months

Over a year

How would you describe your pain or symptoms?

Dull & Achy

Sharp or Stabbing

Tingling or Numbness

Burning Sensation

Tight or Stiff

Comes and goes

Constant & Intense

How long have you been dealing with this issue?

Less than 1 week

1-4 weeks

1-3 month

Over 3 month

On & off for year

How has this affected your life?

Sleep

Mood or Energy

Work or Productivity

Posture or Movement

Exercise or Hobbies

Hasn't affected me much

What have you tried to fix it?

Rest

Stretching

Massage

Physical Theraphy

Chiropractic Care

Medication

Nothing

Would you like Dr. Dan to review your results?

Yes

No

Preferred Contact Method

Call

Text/SMS

Email

Final Step: Contact Info

First Name

Last Name

Phone *

Email *

Postal code *

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