Patient Screening Tool
1.
Am I currently active, or active before my injury?
Yes
No
2.
Do I have an injury or immobility that is limiting me from doing what I want to do on a daily or weekly basis?
Yes
No
3.
Am I willing to learn about my body and put in the work towards making myself better?
Yes
No
4.
Do I currently have goals about my health and my well being that I would like to discuss with Dr. Karla?
Yes
No
5.
Do I want to be pain free and improve your performance and your health?
Yes
No
6.
If you answered YES to the majority of the questions above, Elevate Human Potential is a great health care choice for you! If you have any other comments or questions, please leave them below with your contact information and someone will get back to you!
Current Progress,
0 of 6 answered