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No Cost Phone Consult !
Men's E.D. Care
Learn about E.D. Wave Care
Men's Erectile Dysfunction Score
Muscle & Joint Shock Wave
Heel Pain
>
Plantar Fasciitis
Achilles Tendonitis
Knee Pain
Hip Pain
Low Back Pain
Shoulder Pain
Elbow Pain
Ankle Pain
Fill out form to best diagnosis your Shoulder Pain
Health Insurance will not cover Muscle & Joint Wave Care.
Patients will pay out of pocket for Wave Care, by using Health Savings/ FSA,
debt card, Cash and credit card.
*
Indicates required field
Do you have a budget for Wellness Care
*
Yes
No
Name
*
First
Last
Cell Phone Number
*
Text message
How do you want to be contacted?
*
Text Message
Call
Have you had Surgery to your Shoulder?
Post surgery rehab can cause pain in shoulder
*
Yes
No
I don't recall
Do you have any pain in shoulder that keeps you up at night?
Pain in the Shoulder can create traveling pain down the arm.
*
Yes
No
I don't know
How would you rate your Shoulder pain?
How would you rate your pain?
*
1-3
3-4
5-6
7-8
8-9
10
Prefer not to say
Is your Shoulder
Stuck
or you can't move it within normal motions?
Is it frozen in place and can't move
*
Yes
No
No Sure
Submit
Home
No Cost Phone Consult !
Men's E.D. Care
Learn about E.D. Wave Care
Men's Erectile Dysfunction Score
Muscle & Joint Shock Wave
Heel Pain
>
Plantar Fasciitis
Achilles Tendonitis
Knee Pain
Hip Pain
Low Back Pain
Shoulder Pain
Elbow Pain
Ankle Pain