Please tell us...
Please enter your first name
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Primary reason for wanting to speak to a specialist
I'm in lots of pain and want some tips and advice I can start using right away
I would love to know what's wrong and how long it will take to ease
I'm not sure that you can even help me and talking to someone first would help me decide
Where do you have the MOST pain?
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Please select one
back
hip
neck
TMJ
headache
knee
foot
shoulder
elbow
wrist & hand
whole body
What does It 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
Not knowing what's wrong
Depending upon painkillers
Losing mobility or independence
The fear of needing surgery
How long has your problem been bothering you?
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A few days
1-2 weeks
2-4 weeks
1-3 months
4-6 months
7-11 months
1 - 2 years
3 - 5 years
6 - 10 years
More than 10 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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Please verify that you are human
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