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Please complete this brief survey for a more thorough experience.

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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.

What prior pain treatments have you explored?

Select all prior pain treatments you have explored.

Have you had any spinal images done recently?

Select all diagnostic imaging of your spine you have previously completed.
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