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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

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Breast Health and Mammograms

Breast Reconstruction

Breastfeeding

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Cancer Support Services

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CASTLE

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Diagnostic Imaging - Pediatric

Diet and Wellness Coaching

Ear, Nose and Throat (ENT)

Early Intervention Program

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EMS Continuing Education

Endocrinology - Pediatric

Exuberan

Eye Care

Family Medicine

Female Pelvic Health

Fitness

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Gastroenterology - Pediatric

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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

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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

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Psychiatry

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Quad-Sparing Knee Replacement

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Radiology Imaging

Robotic Surgery

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Skin Care and Massage

Sleep Lab - Pediatric

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Spine Surgery

Sports Medicine

Sports Medicine Kids

Stroke

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Urgent Care

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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

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