• Vital Total Health Medical Group, Inc.

    Vital Total Health Medical Group, Inc.

    www.VitalTotalHealth.com www.VitalOncall.com
  • 710 S Broadway, Ste 212, Walnut Creek, CA  94596

    4200 18th Street, Ste 103, San Francisco, CA  94114

    2929 Summit Street, Ste 103, Oakland, CA  94609

    4439 Stoneridge Road, Ste 110, Pleasanton, CA  94588

    6611 Folsom-Auburn Road, Ste F, Folsom, CA  95630

    291 S La Cienega Blvd, Ste 108, Beverly Hills, CA  90211

    Telephone and Central Fax (925) 388-9800

  • NEUROLOGY QUESTIONNAIRE

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  • NEXT FOUR SECTIONS are NECK PAIN, UPPER LIMB PAIN, LOW BACK PAIN, LOWER LIMB PAIN.  You need to ONLY answer the sections that apply to you.  Eg. If your Neck Pain radiates to your arm, fill out only the NECK section.  Or if you have an elbow injury, then fill UPPER LIMB PAIN only.

  • NECK PAIN: (Starts at neck and radiates to arms)

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  • UPPER LIMB PAIN: (Starts in Upper Limbs)

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  • LOW BACK PAIN: (Starts at back and radiates to legs)

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  • LOWER LIMB PAIN: (Starts in legs and radiates to legs)

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