First Name *

Email *

Phone *

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Do you live in or near Cameron Park? *

Yes, I'm local

I'm within about 45 minutes

No, I'm farther away

How long have you been dealing with shoulder pain or stiffness? *

Less than 3 months

3 to 6 months

More than 6 months

How is your pain affecting your daily activities? *

Can't bend, lift, or move well

Pinch or pain when reaching overhead

Trouble sleeping or getting comfortable

Hard to focus at work

Missing activities with family

Manageable, but getting worse

What have you already tried for your pain? (Select all that apply) *

Pain meds or over the counter drugs

Stretching or home exercises

Other providers (PT, chiropractor, doctor)

Rest, ice, or heat

This is my first attempt at treatment

Are you ready to take action or still exploring options? *

Ready to start and get relief

Exploring, but open to the right solution

Not ready for treatment yet

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