Knee Pain Screening -

Do you have any of the following?
Select all that apply

Knee pain while walking Knee pain while bending Knee pain at night, while sleeping Knee pain after running I have been diagnosed with knee arthritis This is sudden knee pain

How long have you had knee pain?

Less than 1 month 1 to 3 months 3 to 6 months More than 6 months

Is your pain the result of an accident?

Yes No

On a scale of 1 to 10 – what is your pain level?

1

Have you had knee surgery?

Yes No

Are you taking any prescription medication for your pain?

Yes No

Are you interested in a treatment option that is drug free and non-surgical?

Yes No

Your answers indicate:

You may be a candidate for treatment, but further information is needed to make an accurate diagnosis.

We would like to offer you a voucher for a free consultation so that we can better understand the source of your pain and provide you with the information you need to make an informed healthcare decision.

Who do we send the voucher to?

First Name

Last Name

Email

Phone

Knee Pain Screening

Can our NATURAL TREATMENTS relieve your KNEE PAIN?Answer 7 questions to FIND OUT NOW!

Can our NATURAL TREATMENTS relieve your KNEE PAIN?
Answer 7 questions to FIND OUT NOW!