Free Joint Pain Screening

The right care — for every bone in your body.

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Is joint replacement a possibility for you?
Maybe you’re dealing with joint pain. Maybe you’ve even talked to a doctor, but you’re still unsure about the course of treatment that’s right for you.

There’s no reason to live in pain and uncertainty. Answer the questions below to see if you qualify for a free consultation with a St.Vincent surgeon. We’ll contact you within 72 hours after your completed submission to discuss your potential candidacy for joint replacement surgery.

1. Are you experiencing pain in your hip(s) or your knee(s)? *

Yes

a. If yes, is your pain in your hip(s) or your knee(s)?

Hip

Knee

2. Is the pain in you knee or hip joints tolerable but limiting your ordinary activity or work? *

Yes

3. Does the degree of pain and discomfort sometimes require medication stronger than aspirin, acetaminophen or ibuprofen? *

Yes

4. Are the symptoms present more than half the time during a typical month? *

Yes

5. Do you have pain in your knee or hip when climbing stairs without using the railing? *

Yes

6. Are you forced to stop when you walk more than two or three blocks due to pain? *

Yes

7. Do you ever use walking aids such as a cane or walker? *

Yes

8. Do you walk with a moderate limp? *

Yes

9. Do you feel some pain even when you are sitting or lying down? *

Yes

10. Does your knee or hip sometimes give out when you are physically active? *

Yes

11. Do you have a primary care physician? *

Yes

12. Have you seen a physician about your joint pain? *

Yes

13. What is your weight and height? *

14. What is your date of birth? *

15. Is your pain on the left side, or right side? *

Left side

Right side

Please enter your contact information below:

First Name *

Last Name *

Address *

City *

State *

Zip Code *

Phone Number with Area Code *

Email *

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