Did your symptoms start as a result of trauma (eg. a fall, car accident) ?

Have you ever done any radiological examination ?

If so, which ones, when and where (eg. Clinica Ars Medica).

Have you ever taken drugs to treat your symptoms ?

If so, write the name of the drug and its dosage.

Have you ever done any non surgical treatment for this issue ?

If so, which ones and and approximation of the date of the treatment. (eg. physiotherapy, chiropractic, osteopathy, infiltrations or acupuncture)

Have you ever had back surgery to treat your symptoms ?

If so, write if possible the type of surgery, the date and where it happened.

Do you take drugs daily to treat other health issues ?

If so, write the name of the drug and its dosage.