Candidacy Check - Advanced Orthopedics Advanced Orthopedics

Candidacy Check

What condition do you have?
How old are you?
How would you rate your overall health?
Do you smoke cigarettes?
Have you recently had any diagnostic exams done?
How long ago was it taken?
Have you already undergone non-surgical treatment?
If yes, what treatment?
- Medication(s) (pain killers, anti inflammatory, muscle relaxants)
- Chiropractor
- Acupuncture
- Physical therapy
- Nerve block injections
- Cortisone injections
- Other
Have you been recommended for surgery?
If Yes how long ago?
Name
First Last
Email Address
Phone Number
State
Comments