• Take the Quiz and Find Out if Our Minimally Invasive Frozen Shoulder Treatment Can Help You

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  • Date of Birth **
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  • The following questions ask about your feelings and experiences regarding the impact of hemorrhoid bleeding symptoms on your life. Please consider each question as it relates to your experiences with hemorrhoid bleeding during the previous 3 months. There are no right or wrong answers. Please be sure to answer every question by checking the most appropriate box. If the question does not apply to you, please check “none of the time” as your option.

  • During the previous 3 months, how often have your symptoms related to hemorrhoid bleeding:

  • 1. Do you have shoulder pain and stiffness that makes it hard to lift your arm, reach overhead, or behind your back?*
  • 2. Are everyday movements (getting dressed, reaching cabinets, putting on a belt/bras) noticeably limited?*
  • 3. Has a doctor said your shoulder issue is due to another problem (not frozen shoulder)?*
  • 4. Have you been told you may have frozen shoulder?*
  • 5. How long have you had these symptoms?*
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