First Name
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Last Name
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Pick your ideal day for an appointment
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Pick your ideal day for an appointment
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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Tell us the best time
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Where does it hurt?
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Where does it hurt?
Back Pain
Knee Pain
Neck & Shoulder Pain
Elbow Pain
Wrist Pain
Hip Pain
Foot & Ankle Pain
Sports Injury
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What does it stop you from doing?
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What concerns you most?
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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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How long have you suffered or worried?
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I haven't - this is prevention not a cure
1-2 weeks
2-4 weeks
1-3 months
Long enough
Seems like too long (years)
What would be the one thing you would like us to achieve for you?
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What would be the one thing you would like us to achieve for you?
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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