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.
Email *
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? *
Low
High
Please describe any other important details of your condition that I should know about.
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