Application for Knee Pain Treatment

What to expect from your first visit

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In the past 2 weeks, how much has your knee pain…

These questions ask about limitations to your walking due to knee pain during the past 2 weeks. For each statement, please circle the one number that best describes your degree of limitation.
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1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
Selected Value: 1
1 -Not at All 2 - A Little 3 - Moderately 4- Quite a Bit 5 - Extremely
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