First Name
*
Last Name
*
Where does it hurt?
*
Where does it hurt?
Upper Back
Lower Back
Neck/Shoulders
Elbow/Wrist/Hand
Hip/Pelvis
Knee
Hamstring/Thigh/Leg
Ankle/Foot
Headaches/Migraines
Vestubular/Vertigo
Gait & Balance/Weakness
Not sure where it's coming from.
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What does it stop you from doing?
*
How long have you suffered or worried?
*
Haven't - this is prevention not cure
1-2 weeks
2-4 weeks
1-3 months
Long enough
Seems like too long (years)
What concerns you most?
*
What concerns you most?
Not knowing what's wrong
You want to avoid depending upon painkillers to ease pain
Losing mobility or independence due to chronic pain
The risk of facing dangerous surgery due to chronic pain
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Main goal of using our specialist service
*
Main goal of using our specialist service
Ease pain
Ease stiffness
Get active
Stay active
Avoid painkillers
Find out what's wrong
Stay healthy and get fixed before it gets worse
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Pick your ideal day for an appointment
*
Pick your ideal day for an appointment
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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Email
*
Phone
*
Yes! Tell Me About Cost & Availability