What pain points are you experiencing?
Joint pain Back pain Arthritis Muscle soreness Other
How long have you been dealing with these pain points?
Less than 6 months 6 months to 1 year 1-3 years More than 3 years I don't know
How does this pain affect your daily life?
Limits mobility Disrupts sleep Reduces productivity Affects mood Other
What treatments have you tried for your pain?
Medication Physical therapy Exercise Alternative therapies None
Are you open to exploring natural remedies?
Yes No Not sure
All set, how can we reach you?
Name
Email
Phone
(Details here)
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