Am I a Candidate?" 1. What kind of pain or issue are you dealing with? (Select all that apply) Knee pain Shoulder pain Plantar fasciitis Elbow pain (e.g. tennis elbow) Back or neck pain Post-surgical pain Sports injury Other: __________ 2. How long have you been experiencing this issue? Less than 1 month 1–3 months 3–6 months Over 6 months Years 3. What have you tried for relief so far? (Select all that apply) Chiropractic Physical therapy Injections Surgery Medications Nothing yet 4. How is this pain affecting your life? (Select all that apply) Trouble walking or standing Sleep disturbance Can’t exercise or play sports Affects my work Decreased mobility Emotional frustration 5. What are you hoping StemWave can help you do? Avoid surgery Get back to normal movement Play sports again Be more active with family Get out of chronic pain I’m not sure — I just want help 6. Have you had surgery on the problem area? Yes No Considering surgery soon 7. Are you located near Boise, Meridian, Nampa, or Eagle? Yes No I’m willing to travel 8. Would you like us to review your answers and contact you?(Required) Yes No Name(Required) First Last Phone(Required)Email(Required) This quiz helps us evaluate your condition and determine if StemWave may be right for you. Most patients begin with a $49 Test Session (applied to care if continued).
