What type of headache?
Migraine Tension Cluster Other
Frequency of headaches?
Daily Weekly Monthly Sporadic
Severity of pain?
Mild Moderate Severe Excruciating
Current treatments used?
Medication Therapy Lifestyle changes None
Interested in treatment types?
Medication-based Therapy-based Holistic Not sure
Preferred consultation method?
In-person Telehealth No preference
All set, how can we reach you?
Name
Email
Phone
(Details here)
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    Cutting-edge headache treatments.

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