Regenexx in Oklahoma

Lumbar Spine

This questionnaire has been designed to provide you and your treating physician with information as to how your back pain has affected your ability to manage your everyday life. Please answer every section and mark in each section the statement that most accurately applies to you. We realize you may consider that two of the statements in any one section relate to you, but please mark the box which MOST CLOSELY describes you.


This questionnaire should not be utilized in the place of a qualified medical professional. All users agree to the orthobiogen.com disclaimer, which can be found at the bottom of this page when using any content made available through this site. All information provided on www.orthobiogen.com is for informational purposes only.



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