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Specializing in minimally invasive spine surgery
(407) 960-1717
Candidacy Check
Condition Check
Treatment Check
Free MRI Review
Patient Forms
Treatment Check
What condition do you have?
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Bulging Disc
degenerative disc disease
Disc Tear
Facet Joint Disease
Failed Surgery Syndrome
Foraminal Stenosis
Herniated Disc
Pinched Nerve
Radiculitis
Radiculopathy
Sciatica
Spinal Bone Spurs
Spinal Stenosis
Spondylolisthesis
How long have you been experiencing pain?
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A month or less
One to six months
Seven months to a year
A year or more
Have you undergone any of the following tests?
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CT Scan
MRI
X-Ray
Nerve conduction study
Other (specify below)
Other
How long ago was it taken?
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Not Applicable
A month or less
One to six months
Seven months to a year
More than a year
Are you currently undergoing any treatment for your pain?
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Yes
No
If yes, what treatment?
Medication(s) (pain killers, anti inflammatory, muscle relaxants)
Chiropractor
Acupuncture
Physical therapy
Nerve block injections
Cortisone injections
Other
Other
How effective is your current treatment?
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Very
Moderate
Not Very
What other treatments have you undergone in the past? (select all that apply)
Medication(s) (pain killers, anti inflammatory, muscle relaxants)
Chiropractor
Physical therapy
Acupuncture
Nerve block injections
Cortisone injections
Other
Other
Have you been recommended for a specific treatment?
Click on the arrow to choose
Yes
No
If yes, which treatment have you been recommended for?
Medication(s) (pain killers, anti inflammatory, muscle relaxants)
Chiropractor
Acupuncture
Physical therapy
Nerve block injections
Cortisone injections
Other
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