Reconecta Starting Questionnaire Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Would you this Name *FirstLastEmail *Phone numberHow long have you been dealing with this pain or problem?Less than 3 monthsBetween 3 and 12 monthsMore than one yearWhat have you tried so far?PhysiotherapyMedical consultations/ testsMedicationOtherHow does this problem affect your daily life at the moment?What is your main goal for the future if this situation improved?Would you be willing to actively take part in a process, not just receive a treatment?YesNoI’m not sureHow would you prefer to take part in the Reconecta process?Reconecta – individual, in personReconecta – group, in personReconecta – individual, onlineI’m not sure yetComplete the initial questionnaire
