Pre-Consult Elbow Pain Questionnaire
Complete the 15 question survey then you will be able to select a time for the 20-minute consultation with one of our Elbow Coaches. The survey will help us understand your condition. During the video call we will review the following topics:
  • Your elbow pain journey
  • Explain tennis and golfers elbow - what causes it and how to fiix it
  • Review a proven physical therapy technique called scraping and how the Fiix Elbow robot replicates this process
  • Discuss any questions you have
We look forward to helping to get you out of pain!

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First Name *
Last Name *
Email Address *
Phone Number *
How long have you had elbow pain?
 *
Which elbow tendons have pain? (check all the apply)
 *
Required
Rate your tennis / golfer's elbow pain at its worst during activity.  (If you have pain in multiple elbow tendons rate your most painful tendon)
 *
No Pain
Worst Pain
Who have you consulted with in the past to learn you had tennis / golfer's elbow? (check all that apply)
 *
Required
What activities cause your elbow pain? (check all that apply)
 *
Required
What treatments have you tried for your elbow pain? (check all that apply)
 *
Required
How much have you paid to treat / fix your tennis / golfer's elbow?  (Add up all doctors visits, physical therapy, treatments, devices, braces, sleeves, pills, ointments...  Do not include your time)
 *
What is your age?
 *
What is your sex?
 *
What is your profession?
 *
How did you 1st learn about the Fiix Elbow? *
Any additional insights that will help our Elbow Coaches?
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