General Registration Form

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Background Information















































If you have not seen another physician, please select 'no' and continue to the next section.







































Recurrent joint swelling
Loose pieces in joint
Decreased joint movement
Bursitis/tendonitis
Neck/back pain
Sciatica
Recurrent joint pain
Joint/bone infection
Joint laxity (looseness)
Torn cartilage
Ruptured disc
Chest deformity
Dislocated joint
Bone spurs
Brittle bones (osteoporosis)
Torn muscle/ligament/tendon
Abnormal spine curvature
Amputations
Gout
Arthritis
None of the above