Take the quiz Take the quiz If you had to spend the rest of your life with your back as it is currently, how satisfied would you be? Very satisfied Satisfied Not very satisfied Not satisfied at all None Is your back limiting your ability to engage in activity? Not at all A little A lot Completely None Are you happy with your current physical appearance? Completely A little Not really Not at all None How physically active are you currently? Very active Somewhat active A little active Not active at all None How often do you take pain medication for your back? Never Occasionally (1-2 times per week or less) Frequently (5 times per week or more) Daily None On a scale of 0 to 10 (0=none, 10=the most imaginable), rate the level of back pain you experience in a typical day. Please select your answer 0 1 2 3 4 5 6 7 8 9 10 Have you ever worn a back brace because of scoliosis? No Yes None Have you had any imaging (x-ray, MRI, CT scan, etc) of your back in the past 5 years? Yes No None Have you had back surgery? Yes No None Is your back preventing you from living your life to the fullest? Not at all A little A lot Completely None Thank you for completing the quiz!Please enter your contact information on the next page to view your results. Name Email Phone Time's up
