If you wish to take advantage of the online consultation, please complete the questionnaire below, attach it to your scans and send to me direct in Munich.
Your name *
Your age *
Your e-mail address *
Your telephone number
Your address *
Since when do you have pain and where? *
Do you blame any event for these complaints (e.g. accident, heavy lifting..) *
In which position your complaints are worst? (lying down, sitting, standing, walking?) *
By which actions do you get relief? (e.g. bending forward, sitting..) *
Do you experience pins and needles or numbness, temporarily or continuous? *
Do you have a restriction in motion range, loss of strength? *
Have you got images? Which ones? When? Result? *
Which diagnoses have been established up to now? *
Have you been operated upon already or is operation recommended? *
Additional remarks
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