1-888-VIRTUA-3 1-888-VIRTUA-3
Live Chat
My Virtua
Careers
Classes & Events
Giving
About Us
ER Wait Times

Find A Doctor
- Primary & Specialty Care
- Pediatrics
Locations
Most Viewed Locations
View All Locations
Locations Search
Services
Most Viewed Services
View All Services
Services Search

Services A-Z
A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

X

Y

Z

Adolescent Gynecology

Allergy and Immunology - Pediatric

Angioplasty

Arthritis

Arthroscopic Surgery

Balance Testing and Care

Bariatric Weight-Loss Surgery

Behavioral and Mental Health

Behavioral Health - Pediatric (CASTLE)

Bio-identical HRT

Bladder Cancer

Brain and Spine

Brain Surgery

Breast Cancer

Breast Health and Mammograms

Breast Reconstruction

Breastfeeding

Cancer Genetic Counseling and Testing

Cancer Support Services

Cancer Surgery

Cancer Treatment

Cardiac Catheterization

Cardiac Rehabilitation

Cardiology - Pediatric

Cardiovascular Health

CASTLE

Cervical Cancer

Chemotherapy

Chest Pain Care

CHOP at Virtua

Clinical Trials

Colonoscopy

Colorectal Cancer

Colorectal Surgery

Concussion/ImPACT Testing

Cosmetic Plastic Surgery

Critical Care - Pediatric (PICU)

Dentistry

Depression and Pregnancy

Dermatology

Diabetes Care

Diagnostic Imaging - Pediatric

Diet and Wellness Coaching

Ear, Nose and Throat (ENT)

Early Intervention Program

Emergency Medical Services

Emergency Medicine

Emergency Services - Pediatric

EMS Continuing Education

Endocrinology - Pediatric

Exuberan

Eye Care

Family Medicine

Female Pelvic Health

Fitness

Gastroenterology

Gastroenterology - Pediatric

Geriatric Care Management

Gestational Diabetes

Gynecologic Oncology

Hand Surgery and Rehabilitation

Healthy Eating

Heart Disease And Pregnancy

High-Risk Pregnancy Care

Hip Preservation

Hip Replacement

Home Health Care

Hospice Care

Hyperbaric Oxygen Therapy

Immunotherapy

Infertility

Internal Medicine

Joint Replacement Institute

Kidney Cancer

Knee Replacement

Lab Services

LifeCare

Long-Term Care and Rehabilitation

Lung Cancer

Lung Wellness Program

Lymphoma

Maternity

Medical Nutrition Therapy

Medical Oncology

Medical Weight Loss

Menopause

Men's Health

Midwifery

Minimally Invasive Surgery

Mobile Intensive Care Unit

Nephrology

Neurology

Neurology - Pediatric

Neurosurgery

NICU and Special Care Nursery

Obstetrics and Gynecology

Occupational Health

Oncology Nurse Navigation

Ophthalmology - Pediatric

Orthopedics

Orthopedics - Pediatric

Otolaryngology - Pediatric

Ovarian Cancer

Pain Management

Palliative Medicine

Partial Knee Replacement

Pathology

Pediatric Services

Personal Health Navigator

Physical Therapy and Rehabilitation

Podiatry/Foot and Ankle Surgery

Post-Acute Care

Pregnancy and Infant Loss Support

Prenatal Testing/Genetic Counseling

Primary Care

Prostate Cancer

Psychiatry

Pulmonary Medicine

Pulmonology - Pediatric

Quad-Sparing Knee Replacement

Radiation Oncology

Radiology Imaging

Robotic Surgery

Seniors Health

Sexual Health

Sexual Wellness and Pelvic Health

Shoulder Arthroscopy

Skin Cancer

Skin Care and Massage

Sleep Lab - Pediatric

Sleep Medicine

Spa Services

Spine Surgery

Sports Medicine

Sports Medicine Kids

Stroke

Surgery

Surgery and Anesthesia - Pediatric

Teleneurology

Testicular Cancer

Thoracic Surgery

Thyroid Cancer

Type 1 Diabetes

Type 2 Diabetes

Urgent Care

Urology

Urology - Pediatric

Uterine Cancer

Vascular Surgery

Vir tu Spa

Virtua Baby

Virtua for Women

Virtua Medical Group

Virtua Paramedic Education

Weight Loss and Wellness Center

Women's Cardiology

Women's Health

Wound Healing
Patient Tools
Most Viewed Patient Tools
View All Patient Tools
I Want to...

Go

Find A Doctor
- Primary & Specialty Care
- Pediatrics
Locations
Most Viewed Locations
View All Locations
Locations Search
Services
Most Viewed Services
View All Services
Services Search

Services A-Z
A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

X

Y

Z

Adolescent Gynecology

Allergy and Immunology - Pediatric

Angioplasty

Arthritis

Arthroscopic Surgery

Balance Testing and Care

Bariatric Weight-Loss Surgery

Behavioral and Mental Health

Behavioral Health - Pediatric (CASTLE)

Bio-identical HRT

Bladder Cancer

Brain and Spine

Brain Surgery

Breast Cancer

Breast Health and Mammograms

Breast Reconstruction

Breastfeeding

Cancer Genetic Counseling and Testing

Cancer Support Services

Cancer Surgery

Cancer Treatment

Cardiac Catheterization

Cardiac Rehabilitation

Cardiology - Pediatric

Cardiovascular Health

CASTLE

Cervical Cancer

Chemotherapy

Chest Pain Care

CHOP at Virtua

Clinical Trials

Colonoscopy

Colorectal Cancer

Colorectal Surgery

Concussion/ImPACT Testing

Cosmetic Plastic Surgery

Critical Care - Pediatric (PICU)

Dentistry

Depression and Pregnancy

Dermatology

Diabetes Care

Diagnostic Imaging - Pediatric

Diet and Wellness Coaching

Ear, Nose and Throat (ENT)

Early Intervention Program

Emergency Medical Services

Emergency Medicine

Emergency Services - Pediatric

EMS Continuing Education

Endocrinology - Pediatric

Exuberan

Eye Care

Family Medicine

Female Pelvic Health

Fitness

Gastroenterology

Gastroenterology - Pediatric

Geriatric Care Management

Gestational Diabetes

Gynecologic Oncology

Hand Surgery and Rehabilitation

Healthy Eating

Heart Disease And Pregnancy

High-Risk Pregnancy Care

Hip Preservation

Hip Replacement

Home Health Care

Hospice Care

Hyperbaric Oxygen Therapy

Immunotherapy

Infertility

Internal Medicine

Joint Replacement Institute

Kidney Cancer

Knee Replacement

Lab Services

LifeCare

Long-Term Care and Rehabilitation

Lung Cancer

Lung Wellness Program

Lymphoma

Maternity

Medical Nutrition Therapy

Medical Oncology

Medical Weight Loss

Menopause

Men's Health

Midwifery

Minimally Invasive Surgery

Mobile Intensive Care Unit

Nephrology

Neurology

Neurology - Pediatric

Neurosurgery

NICU and Special Care Nursery

Obstetrics and Gynecology

Occupational Health

Oncology Nurse Navigation

Ophthalmology - Pediatric

Orthopedics

Orthopedics - Pediatric

Otolaryngology - Pediatric

Ovarian Cancer

Pain Management

Palliative Medicine

Partial Knee Replacement

Pathology

Pediatric Services

Personal Health Navigator

Physical Therapy and Rehabilitation

Podiatry/Foot and Ankle Surgery

Post-Acute Care

Pregnancy and Infant Loss Support

Prenatal Testing/Genetic Counseling

Primary Care

Prostate Cancer

Psychiatry

Pulmonary Medicine

Pulmonology - Pediatric

Quad-Sparing Knee Replacement

Radiation Oncology

Radiology Imaging

Robotic Surgery

Seniors Health

Sexual Health

Sexual Wellness and Pelvic Health

Shoulder Arthroscopy

Skin Cancer

Skin Care and Massage

Sleep Lab - Pediatric

Sleep Medicine

Spa Services

Spine Surgery

Sports Medicine

Sports Medicine Kids

Stroke

Surgery

Surgery and Anesthesia - Pediatric

Teleneurology

Testicular Cancer

Thoracic Surgery

Thyroid Cancer

Type 1 Diabetes

Type 2 Diabetes

Urgent Care

Urology

Urology - Pediatric

Uterine Cancer

Vascular Surgery

Vir tu Spa

Virtua Baby

Virtua for Women

Virtua Medical Group

Virtua Paramedic Education

Weight Loss and Wellness Center

Women's Cardiology

Women's Health

Wound Healing
Patient Tools
Most Viewed Patient Tools
View All Patient Tools

Live Chat
My Virtua
Careers
Classes & Events
Giving
About Us

Close

Joint Replacement Questionnaire

Are you a candidate for Joint Replacement Surgery? Please take a few moments to fill out the following online form. Thank you. Read our Privacy Statement.

Are you experiencing pain in your knee, hip or groin?

Yes

No

Is pain limiting your activities or has it caused you to change your everyday routine?

Yes

No

Does pain or discomfort sometimes require medication stronger than Aspirin or Tylenol?

Yes

No

Has medication stopped working?

Yes

No

Do symptoms in your affected joint(s) hurt 4 or more days per week?

Yes

No

Do you have pain climbing or descending the stairs?

Yes

No

Does pain force you to stop when walking more than two or three blocks?

Yes

No

Do you ever use walking aids, such as a cane or walker, to assist you with walking?

Yes

No

Do you walk with a moderate limp?

Yes

No

Do you feel pain when you are lying or sitting down?

Yes

No

Does pain make it difficult to sleep at night?

Yes

No

Does your knee or hip sometimes give out when you are physically active?

Yes

No

Do you have trouble putting on your shoes and socks?

Yes

No

1-888-847-8823
Request a Callback
Live Chat

PATIENT TOOLS

Pay Bill
Pre-Registration Forms
Health Insurance
My Virtua
Online Nursery
Patient Bill of Rights
Notice of Non-Discrimination

ABOUT VIRTUA

About Us
Careers
Classes & Events
News Releases
Community
Leadership
Quality
Virtua Foundation
Virtua Medical Group

EMPLOYEES & PHYSICIANS

For Employees
For Physicians
Physician Exchange Portal
Continuing Medical Education
Graduate Medical Education

Copyright © 2000-2019 Virtua Health | Privacy Policy | Terms of Use | Sitemap