Thank you for your interest in working with me.  

This questionnaire is designed to gather important information about you and your condition prior to your appointment.   We will both be working hard to achieve your goals, so please take your time and be as thorough as possible when filling out this form.  This allows us more time during our appointment for a detailed conversation and examination and to make a start on your treatment plan.

Further information about the fees and services available can be found here: https://www.timtrevail.com/feesandservices

Please allow 10-15 minutes to complete the questionnaire.