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Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?
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Meniscal Tears
Osteoarthritis
Bone on bone
Knee Injury
Rate Your Daily Pain
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1
2
3
4
5
6
7
8
9
10
Do You Currently Take Any Medication To Deal With Pain / Discomfort
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Yes
No
Are you currently a patient at another knee pain office or clinic?
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Yes
No
When are you looking to get results?
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Immediately
2 weeks
60 days
90 days and up
What type of Insurance do you have?
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Original Medicare (red, white and blue card)
Medicare with supplemental or secondary insurance (Plan F, Plan G)
Medicare Advantage Plan
United Healthcare
Optum
Aetna
Cigna
Humana
TriCare
Blue Cross Blue Shield
Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname
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Email
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Phone
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I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.
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