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Do you need help with Pain Management? Take our Pain Management/Assessment Questionnaire:
Which part of your body hurts?
*
Lower back
Upper back
Neck
Headache
Shoulder pain
Stomach ache
Joint pain
Hands and wrists
Feet
other
On a scale of one to ten, with ten representing horrible pain and one representing slight discomfort, click on the degree of pain you feel right now:
*
1
2
3
4
5
6
7
8
9
10
Measured in months / years, estimate how long you have suffered this pain:
1-3 months
4-7 months
8-11 months
1 year
2-3 year
More
Name
*
First
Last
*
Last
Email
*
If you have an idea of the cause of your pain, please use the space provided and describe how it started.
*
How did you hear about us?
Web search
Online yellow pages
Yellow page phone book
Magazine or newspaper ad
Other
For security purposes please enter the words below.
Home
About Us
Meet The Team
Conditions and Treatments
Headaches
Sports Injuries
Weight Problems
Whiplash
Low Back and Neck Pain
Auto Accident
Ultrasonic Lipo
Zerona
Patient Center
First Visit
Payment Options
Blog
Testimonials
Contact
