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Patient Information

*Please provide your full legal name as it appears on your driver's license, state identification card, or government issued identification card.
* Required information * Información requerida

Oswestry Back Pain Questionnaire Cuestionario de Oswestry Sobre el Dolor de Espalda

*Pain Intensity *Intensidad del Dolor


*Personal Care *Cuidado Personal


*Lifting *Al Levantar Objectos


*Walking *Al Caminar


*Sitting *Al Sentarse


*Standing *Al Estar de Pie


*Sleeping *Al Dormir


*Sex Life *Vida Sexual


*Social Life *Vida Social


*Traveling *De Viaja


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