Dr. Brown's Posture Perfect Program Screening
I will get back to you personally within 48 weekday hours of receiving your completed screening. If I feel you are a good fit for my program, I will send you more information including pricing and you will have an opportunity to discuss details with me before moving forward.
What is your first name?
What is your last name?
What is your phone number?
How did you hear about the Posture Perfect Program?
Please explain the nature of your back or neck pain in detail. (Include any diagnosis, treatments, medications and surgeries.)
For this program to be a true win for you what would you need to accomplish?
On a scale of 1-10 how motivated are you to solve the underlying cause of your back and/or neck pain?
Please describe any other important details of your condition that I should know about.
Send me a copy of my responses.
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