📍17575 SW Tualatin Valley Hwy

Aloha, OR 97006

📞 503-479-4499

Are you taking pain medications like Gabapentin or Lyrica to help with the pain? *

Yes

No

How long have these symptoms been bothering you? *

Less than 1 year

1 - 3 years

4 - 6 years

6+ years

Do you have any of the following? *

Diabetes

Alcoholism

Undergone Chemotherapy

None of the above

Financing options are available based on your credit. Which option best describes your credit history? *

Below 650

650-700

700-750

750+

Is 17575 SW Tualatin Valley Hwy Aloha, OR 97006 commutable for you? *

Yes

No

What is your zipcode? (This helps to make sure we reaching people close to us) *

Full Name *

Email *

Phone Number *

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