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Welcome to the Minimally Invasive SpineCARE Online Pain Evaluation Tool

The Minimally Invasive SpineCARE’s Online Pain Evaluation Tool is one of the many tools we use to aid us in understanding each individual’s pain better. This process helps us to create the best plan for each individual’s treatment in order to help him or her BACK to living a normal life.

Our Online Pain Evaluation Tool is provided as a complimentary service to individuals visiting our website. Your results will be reviewed by our professional medical staff at the Minimally Invasive SpineCARE Institute, and one of our trained Patient Care Advocates will contact you within 12 to 24 hours to further assist you.

Describe Your Pain

So that we may better assist you on your path to recovery, please fill out all of the questions below as accurately as possible.

Where is your pain located?

How would you describe your pain?

Where is your pain the worst?

How long have you been experiencing this pain?

What was the cause of your pain?

Do you have any associated symptoms?

What makes the pain worse?

What reduces or lessens your pain?

What tests have you had?

What prior course of treatment have you had?

Personal Information

How old are you?

State

First name

Last name

Home Phone

Best time to Call?

Email

Insurance Provider

Insurance Type

Additional Comments or Concerns

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CONTACT REQUEST






*Best Time to Call:

*Have you had an MRI or CTScan in the last 5 years?

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