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Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with Supplemental Coverage (Plan F or Plan G)
- Aetna
- United Healthcare
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

"*" indicates required fields

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment

Which Condition Are You Currently Experiencing?*

Meniscal Tears

Osteoarthritis

Bone on bone

Knee Injury

Rate Your Daily Pain*

Do You Currently Take Any Medication To Deal With Pain / Discomfort*

Yes

Are you currently a patient at another knee pain office or clinic?*

Yes

When are you looking to get results?*

Immediately

2 weeks

60 days

90 days and up

What type of Insurance do you have?*

Original Medicare (red, white and blue card)

Medicare with supplimental or secondary insurance (Plan F, Plan G)

Blue Cross Blue Shield

Cigna

United Healthcare Advantage

Aetna

I have insurance through my employer

other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:

Name / Surname*

First Last

Email*

Phone*

I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with Supplemental Coverage (Plan F or Plan G)
- Aetna
- United Healthcare
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with Supplemental Coverage (Plan F or Plan G)
- Aetna
- United Healthcare
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 6

16%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare plus secondary insurance (Plan F, Plan G)
- commercial PPO insurance (Blue Cross, Aetna, Cigna, United Healthcare, TriCare, or another insurance)

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

"*" indicates required fields

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment

Which Condition Are You Currently Experiencing?*

Meniscal Tears

Osteoarthritis

Bone on bone

Knee Injury

Rate Your Daily Pain*

Do You Currently Take Any Medication To Deal With Pain / Discomfort*

Yes

Are you currently a patient at another knee pain office or clinic?*

Yes

When are you looking to get results?*

Immediately

2 weeks

60 days

90 days and up

What type of Insurance do you have?*

Original Medicare (red, white and blue card)

Medicare with supplimental or secondary insurance (Plan F, Plan G)

Blue Cross Blue Shield

Cigna

United Healthcare Advantage

Aetna

I have insurance through my employer

other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:

Name / Surname*

First Last

Email*

Phone*

I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

"*" indicates required fields

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment

Which Condition Are You Currently Experiencing?*

Meniscal Tears

Osteoarthritis

Bone on bone

Knee Injury

Rate Your Daily Pain*

Do You Currently Take Any Medication To Deal With Pain / Discomfort*

Yes

Are you currently a patient at another knee pain office or clinic?*

Yes

When are you looking to get results?*

Immediately

2 weeks

60 days

90 days and up

What type of Insurance do you have?*

Original Medicare (red, white and blue card)

Medicare with supplimental or secondary insurance (Plan F, Plan G)

Blue Cross Blue Shield

Cigna

United Healthcare Advantage

Aetna

I have insurance through my employer

other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:

Name / Surname*

First Last

Email*

Phone*

I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

"*" indicates required fields

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment

Which Condition Are You Currently Experiencing?*

Meniscal Tears

Osteoarthritis

Bone on bone

Knee Injury

Rate Your Daily Pain*

Do You Currently Take Any Medication To Deal With Pain / Discomfort*

Yes

Are you currently a patient at another knee pain office or clinic?*

Yes

When are you looking to get results?*

Immediately

2 weeks

60 days

90 days and up

What type of Insurance do you have?*

Original Medicare (red, white and blue card)

Medicare with supplimental or secondary insurance (Plan F, Plan G)

Blue Cross Blue Shield

Cigna

United Healthcare Advantage

Aetna

I have insurance through my employer

other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:

Name / Surname*

First Last

Email*

Phone*

I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

"*" indicates required fields

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment

Which Condition Are You Currently Experiencing?*

Meniscal Tears

Osteoarthritis

Bone on bone

Knee Injury

Rate Your Daily Pain*

Do You Currently Take Any Medication To Deal With Pain / Discomfort*

Yes

Are you currently a patient at another knee pain office or clinic?*

Yes

When are you looking to get results?*

Immediately

2 weeks

60 days

90 days and up

What type of Insurance do you have?*

Original Medicare (red, white and blue card)

Medicare with supplimental or secondary insurance (Plan F, Plan G)

Blue Cross Blue Shield

Cigna

United Healthcare Advantage

Aetna

I have insurance through my employer

other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:

Name / Surname*

First Last

Email*

Phone*

I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplimental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- Cigna
- United Healthcare Advantage
- Aetna
- I have insurance through my employer
- other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

"*" indicates required fields

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment

Which Condition Are You Currently Experiencing?*

Meniscal Tears

Osteoarthritis

Bone on bone

Knee Injury

Rate Your Daily Pain*

Do You Currently Take Any Medication To Deal With Pain / Discomfort*

Yes

Are you currently a patient at another knee pain office or clinic?*

Yes

When are you looking to get results?*

Immediately

2 weeks

60 days

90 days and up

What type of Insurance do you have?*

Original Medicare (red, white and blue card)

Medicare with supplimental or secondary insurance (Plan F, Plan G)

Blue Cross Blue Shield

Cigna

United Healthcare Advantage

Aetna

I have insurance through my employer

other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:

Name / Surname*

First Last

Email*

Phone*

I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplimental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- Cigna
- United Healthcare Advantage
- Aetna
- I have insurance through my employer
- other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Medicare Advantage Plan
- Humana
- Aetna
- Blue Cross
- other insurance / I'm not sure what insurance I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplimental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- Cigna
- United Healthcare Advantage
- Aetna
- I have insurance through my employer
- other insurance / I'm not sure what plan I have
- Tricare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.
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Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplimental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- Cigna
- United Healthcare Advantage
- Aetna
- I have insurance through my employer
- other insurance / I'm not sure what plan I have
- Tricare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 6

16%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Cigna
- Care Source / Buckeye Insurance
- Molina

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplimental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- Cigna
- United Healthcare Advantage
- Aetna
- I have insurance through my employer
- other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Aetna
- Blue Cross Blue Shield
- Cigna
- Humana
- Tricare
- United Health Care

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Chronic Knee Pain
- Tearing
- Stiffness
- Joint Degeneration
- Throbbing, Aching Knee Joints
- Proven Results from a Trusted Team

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- United Healthcare
- United Healthcare AARP
- Cigna
- Humana
- Aetna
- other insurance / I'm not sure what my plan is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- United Healthcare
- United Healthcare AARP
- Cigna
- Humana
- Aetna
- other insurance / I'm not sure what my plan is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- United Healthcare
- United Healthcare AARP
- Cigna
- Humana
- Aetna
- other insurance / I'm not sure what my plan is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Medicare Advantage Plan
- Humana
- Aetna
- Blue Cross
- other insurance / I'm not sure what insurance I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with secondary or supplemental insurance (Plan F, Plan G)
- Medicare Advantage Plan
- Blue Cross Blue Shield
- Horizon
- UHC / Oxford PPO
- Aetna
- Cigna
- Another plan / I' not sure what insurance I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Medicare Advantage Plan
- Humana
- Aetna
- Cigna
- Blue Cross Blue Shield
- TriCare / insurance through Veterans Affairs

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 6

16%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with secondary or supplemental insurance (Plan F, Plan G)
- Medicare Advantage Plan through a commercial insurance provider
- Commercial Insurance
- I don't know what my insurance is / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with secondary or supplemental insurance (Plan F, Plan G)
- Medicare Advantage Plan through a commercial insurance provider
- Commercial Insurance
- I don't know what my insurance is / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 6

16%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental insurance (Plan F, Plan G)
- Medicare Advantage Plan
- Cigna
- another insurance / I'm not sure what my coverage is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare Plan F or Plan G
- Blue Cross Blue Shield
- United Healthcare
- Cigna
- Providence
- Aetna
- TriCare
- First Choice
- other insurance / I'm not sure what my coverage is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with secondary or supplemental insurance (Plan F, Plan G)
- Medicare Advantage Plan
- Blue Cross Blue Shield
- Aetna
- United Healthcare
- TriCare
- other insurance / I'm not sure what my plan is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with secondary or supplemental insurance (Plan F, Plan G)
- Medicare Advantage Plan
- Blue Cross Blue Shield
- Aetna
- United Healthcare
- TriCare
- other insurance / I'm not sure what my plan is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F or Plan G)
- Medicare Advantage Plan
- Blue Cross Blue Shield
- United Healthcare
- Aetna
- Cigna
- TriCare
- Humana
- Medicaid

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 6

16%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare with secondary or supplemental insurance (Plan F, Plan G)
- Commercial insurance plan (Blue Cross, United Healthcare, TriCare, Aetna, Humana, other insurance)
- I don't have insurance / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 8

12%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

Which of our offices would be most conveniently-located to you?*
- Morganville, NJ
- Staten Island, NY

What type of Insurance do you have?*
- Original Medicare
- Medicare plus secondary insurance
- Medicare plus supplemental insurance
- Blue Cross Blue Shield
- Aetna
- Cigna
- TriCare
- Humana
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Medicare Advantage Plan through Blue Cross, Humana, Aetna, or another insurance
- Blue Cross Blue Shield
- Aetna
- TriCare
- Highmark

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare plus Secondary Insurance
- Medicare plus Supplemental Insurance
- Aetna
- United Healthcare
- United Healthcare AARP
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare plus Secondary Insurance
- Medicare plus Supplemental Insurance
- Aetna
- United Healthcare
- United Healthcare AARP
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicaid
- Blue Cross, United Healthcare, Aetna, Cigna, TriCare, or another commercial insurance

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medical (red, white, and blue card)
- Medicare with supplemental or secondary insurance (Plan F or Plan G)
- Anthem Blue Cross (PPO, HMO, Medicare replacement or Medicare Advantage)
- United Healthcare
- Aetna
- Cigna

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Medicare Advantage Plan
- United Healthcare
- Health Net
- Aetna
- Kaiser Permanente
- I'm not sure what insurance I have / I would be a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield
- Aetna
- Cigna
- Humana
- I'm not sure what I have / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Medicare Advantage Plan through Humana, United, Aetna, or Blue Cross Blue Shield
- Humana
- United Healthcare
- Aetna
- Blue Cross Blue Shield
- I don't have one of the above insurances / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Humana, United Healthcare, Aetna, Blue Cross, or another commercial insurance
- I don't have one of the above insurances / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medical (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Medicare with Medicaid
- United Healthcare
- Aetna
- Blue Cross Blue Shield
- Cigna
- Connecticare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare
- BlueCross BlueShield
- Aetna
- Cigna
- Hap
- Humana
- Tricare
- Others

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental insurance (Plan F or Plan G)
- Medicare Advantage Plan
- Commercial PPO insurance
- other insurance / I'm not sure what my plan is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a NO-OBLIGATION Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental insurance (Plan F or Plan G)
- Medicare Advantage Plan
- Tricare
- CareFirst
- Aetna
- Ambetter
- United Healthcare
- Humana
- Blue Cross Blue Shield
- VA insurance

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medical (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- TriCare
- CarePlus
- other commercial PPO insurance (Blue Cross, United Healthcare, Cigna, Aetna, etc)

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F or Plan G)
- Medicare Advantage Plan through Blue Cross, Humana, Cigna, Aetna, or United Healthcare
- Blue Cross Blue Shield
- Humana
- Cigna
- Aetna
- United Healthcare
- other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F or Plan G)
- Medicare Advantage Plan through Blue Cross, Humana, Cigna, Aetna, or United Healthcare
- Blue Cross Blue Shield
- Humana
- Cigna
- Aetna
- United Healthcare
- other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F or Plan G)
- Medicare Advantage Plan through Aetna or Blue Cross Blue Shield
- Railroad Medicare
- Blue Cross Blue Shield
- Aetna
- Cigna (we DO NOT accept Cigna Advantage or Health Spring plans)
- other insurance / I'm not sure what plan I have

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan G or Plan F)
- Medicare Advantage Plan
- Railroad Medicare
- Aetna
- Cigna
- Blue Cross Blue Shield
- Humana
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental insurance (Plan F, Plan G)
- Bright Path
- Select Health
- Blue Cross Blue Shield PPO
- Blue Cross Medicare Advantage
- United Healthcare Medicare Advantage
- Regence PPO
- Regence Medicare Advantage
- Select Health PPO
- Select Health Medicare Advantage
- PacificSource PPO
- PacificSource Medicare Advantage
- Humana Medicare Advantage HMO
- Mountain Health Co-Op

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare plus secondary insurance (Plan F, Plan G)
- commercial PPO insurance (Blue Cross, Aetna, Cigna, United Healthcare, TriCare, or another insurance)

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
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Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with Supplemental Coverage (Plan F or Plan G)
- Aetna
- United Healthcare
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with Supplemental Coverage (Plan F or Plan G)
- Aetna
- United Healthcare
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental insurance (Plan G, Plan F)
- commercial PPO insurance (Blue Cross, Cigna, Aetna, United Healthcare, or others)

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental insurance
- Medicare with secondary insurance
- Blue Cross Blue Shield
- Aetna, United Healthcare, Tricare, Humana, or another commercial insurance

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental insurance
- Medicare with secondary insurance
- Medicare Advantage Plan
- Blue Cross Blue Shield
- United Healthcare
- Cigna
- Aetna

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with Supplement
- Medicare with Secondary Insurance
- Medicare Advantage Plan
- Traditional Medicaid
- Blue Cross Blue Shield
- United Healthcare
- Cigna
- TriCare
- other insurance

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare plus secondary insurance
- Medicare plus Supplemental Insurance (Plan F)
- Medicare Replacement Plan
- United Healthcare
- United Healthcare AARP
- Humana
- Aetna
- TriCare
- Cigna
- MedCost

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Federal Medicare with Supplementary Insurance
- Medicare Advantage Plans
- Aetna
- Aetna ESA

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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*
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Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment

Which Condition Are You Currently Experiencing?*

Meniscal Tears

Osteoarthritis

Bone on bone

Knee Injury

Rate Your Daily Pain*

Do You Currently Take Any Medication To Deal With Pain / Discomfort*

Yes

Are you currently a patient at another knee pain office or clinic?*

Yes

When are you looking to get results?*

Immediately

2 weeks

60 days

90 days and up

What type of Insurance do you have?*

Original Medicare

Medicare Plus Supplemental Insurance

Medicare Plus Secondary Insurance

Traditional Medicaid

RR Medicare

Anthem Blue Cross

Humana

Cigna

Medical Mutual

Molina

Valor

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:

Name / Surname*

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I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 8

12%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Federal Medicare w/ Secondary Coverage
- VA insurance
- I don't have insurance / I would be a cash patient
- United Healthcare
- Cigna
- Aetna
- Tricare

Are you currently enrolled in any Kaiser Permanente or HMO Medicare replacement plan?*
- Yes
- No

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare plus secondary insurance
- Medicare plus supplemental insurance
- Blue Cross Blue Shield
- Aetna
- Cigna
- TriCare
- Humana
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental insurance
- Medicare with secondary insurance
- Medicare Advantage Plan (Medicare as secondary insurance)
- Aetna
- Blue Cross Blue Shield
- Cigna
- Humana
- Tricare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When would you prefer to be contacted?*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare plus supplemental insurance
- Medicare plus secondary insurance
- Aetna
- AvMed
- Blue Cross Blue Shield
- Cigna
- GEHE
- Humana
- Humana Choice
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental coverage
- Medicare with secondary coverage
- Blue Cross Blue Shield
- Cigna
- other insurance

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with Supplemental Insurance
- Medicare
- United Healthcare AARP
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Traditional Medicaid (disability)
- Medicare Advantage Plan (Medicare through a commercial provider)
- Peachstate (Medicaid)
- Ambetter
- Wellcare (Medicare + Medicaid)
- Blue Cross Blue Shield, Anthem
- Aetna
- Cigna
- United Healthcare
- Other insurance / I'm not sure who my primary insurance provider is

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare plus Secondary Insurance
- Medicare plus Supplemental Insurance
- Aetna
- United Healthcare
- United Healthcare AARP
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental insurance
- Medicare with secondary insurance
- Medicare Advantage Plan
Please note that we are ONLY in-network with original Medicare (red, white, and blue card). We are not in-network with any commercial insurances such as Blue Cross, Aetna, Cigna, United Healthcare, or any other commercial insurance plans.

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
- Medicare with supplemental insurance
- Medicare with secondary insurance
- other insurance / I'm not sure
**Please note that our office is currently ONLY in-network with traditional Medicare (red, white, and blue card).

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare
- BlueCross BlueShield
- Aetna
- Cigna
- Hap
- Humana
- Tricare
- Others

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental coverage
- Medicare with secondary coverage
- Blue Cross Blue Shield
- Cigna
- other insurance

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- United Healthcare
- Aetna
- Humana
- Blue Cross Blue Shield
- Medicare
- Medicare Advantage Plans
- Medicaid

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare plus supplemental insurance
- Medicare plus secondary insurance
- Aetna
- AvMed
- Blue Cross Blue Shield
- Cigna
- GEHE
- Humana
- Humana Choice
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Regence
- Cigna
- Aetna
- Humana
- DMBA
- UMR
- Select Health (we DO NOT accept Select Health Advantage Plans)
- Medicare Advantage Plan through Regence, Cigna, Aetna, Humana
- Select Advantage

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue)
- Medicare with Supplemental or Secondary Coverage (Plan F, Plan G)
- Medicare Advantage Plan
- United Healthcare
- Cigna
- Aetna
- other insurance

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 6

16%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Joint Pain Assessment
Which Condition Are You Currently Experiencing?*
- Hip Pain
- Shoulder Pain
- Elbow Pain
- Pain and other Joints

Rate Your Daily Joint Pain from 1-10*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently seeking any surgical or non-surgical care for joint pain?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Humana Medicare
- Aetna Medicare
- Blue Cross Blue Shield
- Aetna
- Humana
- Cigna

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Blue Cross Blue Shield (of New Hampshire or Massachusetts)
- United Healthcare
- Cigna
- Humana
- Tricare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare part B
- Blue Cross Blue Shield
- Anthem Blue Cross Blue Shield
- Carefirst
- Aetna
- Priority Partners
- Johns Hopkins Community Plan
- Cigna
- Coventry
- AARP
- United Health Care
- Tricare for Life
- Humana
- Union Insurance (Steam Fitters, Council of Carpentry)

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare Advantage Plan
- Humana
- Humana Gold HMO
- United Healthcare / AARP
- Wellcare
- RR Medicare
- Blue Cross Blue Shield
- Anthem

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental or secondary insurance (Plan F, Plan G)
- Medicare Advantage Plan
- Cigna
- United Healthcare
- Blue Cross Blue Sheild

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental insurance
- Medicare with secondary insurance
- Medicare Advantage Plan (Medicare as secondary insurance)
- Aetna
- Blue Cross Blue Shield
- Cigna
- Humana
- Tricare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
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Step 1 of 7

14%

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- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white and blue card)
- Medicare with supplemental insurance
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare (red, white and blue card)
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare (red, white and blue card)
- Medicare with Supplemental Insurance
- Medicare with secondary Insurance
- I don't have insurance / I am a cash patient
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare (red, white and blue card)
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare (red, white, and blue card)
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
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Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
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Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment

Which Condition Are You Currently Experiencing?*

Meniscal Tears

Osteoarthritis

Bone on bone

Knee Injury

Rate Your Daily Pain*

Do You Currently Take Any Medication To Deal With Pain / Discomfort*

Yes

Are you currently a patient at another knee pain office or clinic?*

Yes

When are you looking to get results?*

Immediately

2 weeks

60 days

90 days and up

What type of Insurance do you have?*

Original Medicare

Medicare Plus Supplemental Insurance

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Traditional Medicaid

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TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
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TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare
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TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
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- Blue Cross Blue Shield
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Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare plus Secondary insurance
- Medicare plus Supplemental Insurance
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14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare plus secondary insurance
- Medicare plus Supplemental Insurance
- I don't have insurance / I'm a cash patient
- Medicare Advantage Plan
- Blue Cross Blue Shield
- United Healthcare
- Aetna
- Cigna
- TriCare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare w/ secondary insurance
- Medicare w/ Supplemental Insurance
- Blue Cross Blue Shield
- Aetna
- Cigna
- Humana
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare plus Supplemental Insurance
- Medicare plus Secondary Insurance
- Cigna

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare plus secondary insurance
- Medicare plus supplemental insurance
- Blue Cross Blue Shield
- United Healthcare
- United Healthcare AARP
- Cigna
- Humana
- Aetna

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare plus secondary insurance
- Medicare plus Supplemental Insurance (Plan F)
- Medicare Replacement Plan
- United Healthcare
- United Healthcare AARP
- Humana
- Aetna
- TriCare
- Cigna
- MedCost

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare plus secondary insurance
- Medicare plus supplemental insurance
- Blue Cross Blue Shield
- United Healthcare
- United Healthcare AARP
- Cigna
- Humana
- Aetna

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare + Supplemental Insurance
- Medicare + Secondary Insurance
- I don't have insurance / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Original Medicare
- Medicare Plus Secondary Insurance
- Medicare Plus Supplemental Insurance
- Blue Cross Blue Shield
- TriCare
- Aetna
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare plus Secondary Insurance
- Medicare plus Supplemental Insurance
- Aetna
- United Healthcare
- United Healthcare AARP
- Cigna
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare plus Secondary Insurance
- Medicare plus Supplemental Insurance
- TriCare
- Aetna
- Cigna
- Blue Cross Blue Shield
- Humana
- United Healthcare
- Ambetter

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare plus Supplemental Insurance
- Medicare plus Secondary Insurance
- United Healthcare
- Humana
- Blue Cross Blue Shield

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare plus Supplement
- Medicare plus Secondary
- I don't have insurance / I am a cash patient
- Medicare Advantage Plans
- United Healthcare
- Blue Cross Blue Shield
- Aetna
- Cigna
- TriCare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Medicare Plus
- United Healthcare
- United Healthcare AARP
- Tricare
- Cigna
- Blue Cross Blue Shield
- No insurance / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare Part B
- Commercial PPO plan with out-of-network benefits
- I don't have insurance / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare part B
- Commercial Insurance with out of Network Benefits
- I don't have insurance / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare part B
- Blue Cross Blue Shield
- Anthem Blue Cross Blue Shield
- Carefirst
- Aetna
- Priority Partners
- Johns Hopkins Community Plan
- Cigna
- Coventry
- AARP
- United Health Care
- Tricare for Life
- Humana
- Union Insurance (Steam Fitters, Council of Carpentry)

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Diabetic Foot Wound
Which types of diabetic foot wounds are you currently experiencing?*
- Ulcers
- Deep, bleeding wounds
- More than one type

Are these wounds CHRONIC, meaning that you experience them constantly?*
- Yes
- No

On a scale of 1-10, please rate your daily pain:*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

How long have you been experiencing chronic foot wounds caused by diabetes?*
- Less than 1 year
- More than 1 year
- More than 5-10 years

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

This treatment is only covered by Federal Medicare; are you currently a Federal Medicare patient?*
- Yes
- No

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Medicare Plus
- United Healthcare
- United Healthcare AARP
- Tricare
- Cigna
- Blue Cross Blue Shield
- No insurance / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Medicare Plus
- United Healthcare
- United Healthcare AARP
- Tricare
- Cigna
- Blue Cross Blue Shield
- No insurance / I'm a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare
- BlueCross BlueShield
- Aetna
- Cigna
- United HealthCare
- Others

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Humana Medicare
- Aetna Medicare
- Blue Cross Blue Shield
- Aetna
- Humana
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Medicare Advantage Plans
- Blue Cross Blue Shield
- Aetna
- Aetna ESA
- United Healthcare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Humana Medicare
- Aetna Medicare
- Blue Cross Blue Shield
- Aetna
- Humana
- Cigna

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 8

12%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Federal Medicare w/ Secondary Coverage
- VA insurance
- I don't have insurance / I would be a cash patient
- United Healthcare
- Cigna
- Aetna
- Tricare

Are you currently enrolled in any Kaiser Permanente or HMO Medicare replacement plan?*
- Yes
- No

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
When is the best time to reach you?*
- Before Noon
- Between Noon and 2 PM
- Between 2 PM and 5 PM
- After 5 PM
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Federal Medicare with Supplementary Insurance
- Medicare Advantage Plans
- Aetna
- Aetna ESA

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- United Healthcare
- Aetna
- Humana
- Blue Cross Blue Shield
- Medicare
- Medicare Advantage Plans
- Medicaid

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Federal Medicare
- Federal Medicare with Secondary Coverage
- Medicare Advantage Plans
- United HealthCare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Blue Cross Blue Shield
- United Health Care
- UHC / AARP
- Federal Medicare
- Federal Medicare with secondary coverage
- No Insurance / I am a cash patient

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- BlueCross BlueShield
- United HealthCare
- Medicare
- Others

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Traditional Medicare
- Medicare + Supplemental Insurance
- Medicare + Secondary Insurance
- Aetna
- Blue Cross Blue Shield
- I don't have insurance / I am a cash patient
- WellCare

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare
- BlueCross BlueShield
- Aetna
- Cigna
- United HealthCare
- Others

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare
- BlueCross BlueShield
- Aetna
- Cigna
- United HealthCare
- Others

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare
- BlueCross BlueShield
- Aetna
- Cigna
- Hap
- Humana
- Tricare
- Others

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 7

14%

TAKE OUR 10 SECOND QUIZ
Find Out If You Qualify for a FREE Consultation / Knee Assessment
Which Condition Are You Currently Experiencing?*
- Meniscal Tears
- Osteoarthritis
- Bone on bone
- Knee Injury

Rate Your Daily Pain*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10

Do You Currently Take Any Medication To Deal With Pain / Discomfort*
- Yes
- No

Are you currently a patient at another knee pain office or clinic?*
- Yes
- No

When are you looking to get results?*
- Immediately
- 2 weeks
- 60 days
- 90 days and up

What type of Insurance do you have?*
- Medicare
- BlueCross BlueShield
- Aetna
- Cigna
- Hap
- Humana
- Tricare
- Others

Thank you for providing this case information. Please complete the form below to send these assessment results to our team:
Name / Surname*
First Last
Email*
Phone*
*
- I acknowledge that upon submitting this assessment I will be contacted via phone, email, or SMS by a treatment coordinator with a follow-up discussion within 24-48 hours.

Step 1 of 2: Please fill out the form below ....
Select below the session you would like to attend:*
Topic: Non-Surgical Joint Pain Relief*
Please enter your information below for event verification:
First and Last Name*
Email Address*
Mobile Number*
Guest Name*
Please tell us how we can help you:
What Condition / Symptoms Are You Currently Experiencing?
How Is This Condition / Symptoms Affecting Your Daily Life?
When Are You Looking To Get Results?
When would you like us to call you to confirm?*
*
- I acknowledge that all the information above is correct and upon submitting this form a patient coordinator from the clinic may call for follow up questions.

Step 1 of 2: Please fill out the form below ....
Select below the session you would like to attend:*
Topic: Non-Surgical Knee Pain Relief*
Please enter your information below for event verification:
First and Last Name*
Email Address*
Mobile Number*
Guest Name*
Please tell us how we can help you:
What Condition / Symptoms Are You Currently Experiencing?
How Is This Condition / Symptoms Affecting Your Daily Life?
When Are You Looking To Get Results?