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Where is your pain located?
Select all locations that apply.
How would you rate your pain's severity?
Rate your pain by number, please select one.
How long have you been experiencing this pain?
Share your pain duration, please select one.
1 year or more
What prior pain treatments have you explored?
Select all prior pain treatments you have explored.
Over-the-counter pain medications
Prescribed pain medications
Have you had any spinal images done recently?
Select all diagnostic imaging of your spine you have previously completed.
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Please note that we do not currently participate in Medicaid.