Less than 1 week Post surgery form

This area is only for the patients who had surgery with us.

Contact Information:
Name Email
Age Occupation
City State
Medical Information:
Today's Date(mm/dd/yy)
Date of surgery(mm/dd/yy)
How was your trip home?
Describe any symptoms you have now
( pain, numbness, weakness)
How are your symptoms different
in comparison to prior to your procedure?
What medication are you taking and how often?
Are you having or have you arranged any physical therapy or traction (at home or at a therapy center?)
When are you planning to return to work?

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