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📋 New patient questionnaire
Staff: exit

Please answer what you can — your care team will review everything with you. When you're finished, press the green button at the bottom and hand the iPad back to the front desk.

👤 About you

💳 Insurance

The fastest way: take a photo of your insurance card and we'll fill this in for you.

🩺 Today's visit

📚 Your health history

📏 How your pain affects daily life

For each section, tap the ONE statement that best describes you today. Skip any that don't apply. (Oswestry Disability Index)

💬 Your experience with us

Optional — feel free to skip these if this is your first visit.