Assessing Your Problem


How severe is your problem?

The following surveys ask specific questions that pertain directly to your problem. By answering the questions in the survey, we may be able to better asses the severity of your problem and over time, your response to treatment.

Please select the survey that applies to your particular problem and answer the questions inside. Please bring this survey with you when you come to your appointment. If you are being treated for a particular problem, complete a new survey every time you see us so that we may estimate if your problem is improving or not.

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