Allied Physicians and Weight Loss Please fill out this short survey to be entered to win 2 tickets to the MVC Men's Basketball tourney. Brought to you by Allied Physicians and Weight Loss 1. Which of the following best describes your relationship with Southern Illinois Athletics? Current student Alumnus/Former student Faculty/Staff Just a fan of Athletics 2. Do you live or work within 30 miles of Carbondale, Illinois? Yes, I live or work within 30 miles of Carbondale No, I live and work further away from Carbondale 3. What is your age? 18 - 34 35 - 54 55 or older Prefer not to answer 4. Which of the following issues have you had during the past 6 months? (Select all that apply) Weight Problems Migraines Depression Mid Back Pain Neck Tension or Pain Carpal Tunnel Shoulder Pain Headaches Problems Sleeping Arm/Elbow Pain AsthmaAllergies/Sinus PMS Digestive Troubles Ankle/Foot Pain Unresolved Pain Despite Medical Treatment Upper Back Pain Sciatic Pain Low Energy Arthritis/Bursitis Hip/Leg Pain Low Back Pain None Next
