Do Your Self-Assessment

Do a self-assessment to find out some of the best options for your own circumstances.

Do you have a history of cancer?

Yes No

Have you experienced recent unexplained weight loss?

Yes No

Do you have a known immunosuppressive disorder?

Yes No

Have you used steroids for a prolonged period of time?

Yes No

Are you an intravenous drug user?

Yes No

Do you have signs of a urinary tract infection?

Yes No

Is your pain increased or not relieved by rest?

Yes No

Do you have a fever?

Yes No

Have you experienced trauma or had an accident?

Yes No

Have you experienced bladder or bowel incontinence?

Yes No

Do you have numbness or feel clumsy in both feet?

Yes No

Do you have burning, shooting or deep aching pain extending down your leg?

Yes No

Do you have tingling or pins and needles down your leg or in your foot?

Yes No

Do you have numbness in your leg or in your foot?

Yes No

Do you have a feeling of weakness or clumsiness in your leg, ankle or foot?

Yes No

Are you worried you will be like this forever?

Yes No

Do you feel you can’t help yourself?

Yes No

Does it concern you that you could damage yourself more?

Yes No

Do you feel you can no longer live a normal life?

Yes No

Do you think no one understands your problem?

Yes No

6 out of 5

Your Name

Your Email Address

You Phone

Time is Up!

Time’s up