Name* Email* How did you get hurt? * I fellIt happened graduallyThere was an accidentI was injured at work How strong is your pain? Mild - it doesn't interfere with everyday lifeModerate - I know it's there all the timeSevere - I can't stand it What does your pain feel like? burningsharpachestiffnessadiating/shootingtingling/numbnessother When did your pain start? (approximation okay) Is there anything else you'd like to add? (if choosing option 4, be sure to include as many details about your pain as possible)
