Spine Assessment

Pain Location & Type

Where exactly do you feel discomfort, pain, or tightness?*

Since how long are you facing these symptoms?*

How would you describe your pain or discomfort?*

When does your problem worsen?*

What gives you relief?*

Have you undergone MRI, CT scan or X-Ray of the spine?*

Your medical reports are encrypted and reviewed only by our spine specialists at Sukhayu Ayurved

Date of MRI*

File

Drop files here or

Age*

Gender*

Do you have Diabetes / Thyroid / Hypertension*

Have you undergone spinal surgery before?

Current Medication

How would you like to proceed?*

Name*

First Last

WhatsApp Number*

Email*

Email

This field is for validation purposes and should be left unchanged.