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First Name
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Where did they hear about us?
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Where does it hurt?
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How long have they suffered?
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Haven't - this is prevention not cure
A few days
1-2 weeks
2-4 weeks
1-3 months
Long enough
Seems like too long (years)
What concerns you most?
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Not knowing what's wrong
Depending upon painkillers
Losing mobility or independence
The risk of facing dangerous surgery
Not being able to workout/stay active
Not being able to play sports
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Other concerns (specific)
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No1 thing they'd like to achieve
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P.S. section
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