Please tell us...
Please enter your first name
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Primary reason for wanting to speak to a specialist
I have pain that I'd like to get rid of
I get stressed easily and would like to learn how to manage it
I get anxious or depressed and it affects my quality of life
I need some help losing weight
What does this problem STOP you from doing?
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What is your MAIN concern that has you considering getting help?
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Please select one
the pain you're experiencing
being limited in activities
having too much stress
that you can't get your mind to turn off
that you don't feel comfortable in your body
How long has your problem been bothering you?
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less than a week
1 wk - 1 month
1-3 months
4-6 months
7-12 months
1-2 years
more than 2 years
What is the best time of day to reach you by phone?
Before 8 am
8 am to noon
Noon to 5pm
After 5 pm
Doesn't matter. Call me as soon as possible
What is the best day to reach you by phone?
Please select one
Monday
Tuesday
Wednesday
Thursday
Friday
As soon as possible
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So we can arrange this FREE Phone Consultation for you, please tell us:
Best Phone Number
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Best E-mail
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