What pain symptoms are you experiencing right now?
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Sharp stabbing pain
Pins & needles
Tingling like ants crawling on feet
Numbness
Loss of balance
On a scale of 1-10, 1 being hardly any pain and 10 being excruciating, how would you rate your pain?
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1
2
3
4
5
6
7
8
9
10
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First Name
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Last Name
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Email
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Phone
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