3 weeks wellness success program
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Question 1 of 9
Gender?
Male
Female
Question 2 of 9
What is your age?
Question 3 of 9
Do you sit long hours while working?
Yes
No
sometimes
Question 4 of 9
Do you complete repetitive movements at your work?
Question 5 of 9
Rate your pain 1-10 (1 not much pain, 10 chronic pain)
1
2
3
4
5
6
7
8
9
10
Question 6 of 9
Do your aches and pains interfere with your sleep?
Sometimes
Question 7 of 9
Are you worried that movement/exercise will make your pain worse?
Question 8 of 9
What triggers your pain?
Question 9 of 9
What improves your pain?