Please send us your information through the form below and download our pain form by clicking this link
https://www.hqbk.com/hq-pain-diagram-form.pdf use the
descriptive symbols on the body outlines in the document to describe the
location of your problem. In addition, mark the levels of your pain on the
analog line at the bottom of the picture. You may the print and fax it to
(718) 646-1911 or scan and e mail it to
info@hqbk.com. Thank you for
contacting us.
