Spinal Decompression Survey

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Spinal Decompression SurveyDr. Devin Young2019-05-15T15:59:51-07:00

Complete This Survey to See If You Are a Candidate for
Non-Surgical Spinal Decompression and NUCCA Spinal Care

Please Complete the Questionnaire Below.
To See If You Qualify by Phone, Please Call Our Office at (619) 313-5403.

This Survey Could Change Your Quality of Life
Please check any or all of the primary pain complaints you are experiencing
- Neck
- Low Back
- Buttocks
- Hip
- Leg
- Calf
- Foot
- Toes
How long have you had the pain?
- Less than a month
- More than 6 weeks
- More than 6 months
- More than 1 year
Which best describes the frequency of your pain?
- Intermittent (0-25% of day)
- Occasional (26-50% of day)
- Frequent (51-75% of day)
- Constant (76-100% of day)
Have you already contacted a doctor about your pain?
- Yes
- No
Have you had back surgery?
- Yes
- No
Are you scheduled for back surgery?
- Yes
- No
Have you been diagnosed with any of the following
- Disc Herniation
- Disc Bulge
- Sciatica
- Spinal Stenosis
- Disc Degeneration
- Spondylolisthesis
My condition and pain has affected my activities as follows
- Pain Sitting
- Pain Standing
- Trouble Walking
- Interrupted Sleep at NIGHT
- Decreased Activities
- Decreased Pace
When is your pain at its worst? Describe how you feel and are affected
When was the last time you felt really great?
If there is a way to relieve your pain with one of our advanced non-surgical treatment programs, are you interested in scheduling a consult with our doctor?
- Yes
- No
What is the best time to contact you?
- Morning
- Afternoon
- Evening
Full Name*
First Last
Phone*
Email*
Address*
Street Address Address Line 2 City State ZIP Code

Patient Testimonials

It's Been Years

"This is the first time I've felt like my body is back to normal in a very long time. I can stand without low back pain and sleep through the night without sciatica pain. There have also been other improvements that I did not expect, less anxiety and more confidence."

Heidi F.

I Was a Skeptic

I Won't Need Surgery

"Drastically improved my neck.
No more neck pain, I won't need
surgery anymore! Dr. Young is
great at keeping me in shape.
Great location and superb service!
I recommend them,
check them out!"

Stephen S.

Superb Service

On the Cutting Edge

"I had shoulder and neck tension for years, often getting massages to manage the pain. I have been seeing Dr. Young for about 5 months and my pain is gone, my posture is better, and I have had several other physical health improvements that feel like an added bonus!"

Cassandra P.

NUCCA Is Amazing

2425 Camino Del Rio South #100
San Diego, CA 92108
(619) 313-5403

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Spinal Decompression Survey

Complete This Survey to See If You Are a Candidate forNon-Surgical Spinal Decompression and NUCCA Spinal Care

Please Complete the Questionnaire Below.To See If You Qualify by Phone, Please Call Our Office at (619) 313-5403.

This Survey Could Change Your Quality of Life

Complete This Survey to See If You Are a Candidate for
Non-Surgical Spinal Decompression and NUCCA Spinal Care

Please Complete the Questionnaire Below.
To See If You Qualify by Phone, Please Call Our Office at (619) 313-5403.