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What is your problem?

What sports / activities do you participate in?

What other health problems do you have or have you had?

Are you taking medication for anything? If so what?

Cause of problem?

What aggravates it?

History of your problem?

Occupation?

I understand that the advice given to me is only intended as an indication of the possible cause of my problem and that an accurate diagnosis can only be made from a full physical examination.