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ATTENTION: KNEE PAIN, SUFFERERS! CHECK OUT KNEE PAIN RELIEF THERAPY BEFORE GOING UNDER THE KNIFE!

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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

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*

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*

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*

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 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*

1

2

3

4

5

6

7

8

9

10