Other Question Title * 1. Please enter your full name: Question Title * 2. Date of Birth: Question Title * 3. When did your pain or injury begin? Question Title * 4. What happened? If you sustained an injury, what was the mechanism? Question Title * 5. Where is your pain located? Front (anterior) Inside (medial) Outside (lateral) Backside (posterior) Deep Superficial, just under the skin Other (please specify) Question Title * 6. Is the pain increasing, decreasing, or staying the same since it began? Increasing Decreasing Same Question Title * 7. What activities are you unable to perform due to pain or dysfunction? Question Title * 8. What previous treatment have you received for this problem? Rest, Ice, Compression, or Elevation Over-the-counter medication Prescription Anti-inflammatory medication Prescription Narcotic (Pain) medication Physical therapy Injections Brace Surgery Other (please specify) Question Title * 9. At what email address would you like to be contacted? Question Title * 10. If you would like us to contact you by phone, please provide the best number to reach you: Done