Fill out the survey to see if

Tissue Regenerative Therapy

is right for you!

Once you fill out the survey our team will be reaching out to you through text and email.

While Radial Pressure Wave Therapy is very safe there are a few conditions where it is not indicated.

Filling out the survey helps us determine the right direction for your problem.

Is Shockwave Therapy right for you?

First Name *

Last Name *

Cell Phone *

Email *

Date of birth

Please complete the following questions.

How often do you experience pain?

How bad is your pain?

Pain Intensity *

What is the impact on your daily life?

Pain Impact On Your Life *

I can do anything I want without limitations.

The pain affects some of my activities.

I have had to change or stop doing certain activities because of the pain.

The pain prevents me from doing most of my daily activities.

The pain wakes me up at night.

Please check any that apply.

Things that might affect Shockwave Therapy

How long have you had your problem?

Duration of your symptoms

Less than 3 months but more than 2 weeks.

Greater than 3 months but less than a year.

Greater than a year.

Have you tried other treatments?

Have you tried one or more treatments for your problem? *

Yes

No

Thank you for sharing your information. Shockwave/Radial Pressure Wave Therapy can be a great adjunctive treatment with other therapies and can improve conditions that are having trouble getting better.

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Want to try treating your Plantar Fasciitis pain on your own?

Fill out the survey to see if

Once you fill out the survey our team will be reaching out to you through text and email.

Want to try treating your Plantar Fasciitis pain on your own?

Check out this link and we will connect you with content through text and email.

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