First Name *

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Pick your ideal day for an appointment

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Best time for a call back? *

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After 5pm

Anytime

What does it stop you from doing?

What concerns you most? *

What concerns you most?

The pain
Fear of not being able to keep active
Not knowing whats wrong
Avoiding painkillers
No sign of improvement
Future ill health
Difficulty with intimacy/conception
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How long have you suffered or worried? *

A few days

1-2 weeks

2-4 weeks

1-3 months

Seems like too long (years)

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