Pacific Mobile Massage, L.L.C.
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Medical Info
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Additional Info
Conditions
Area of Complaint
Neck
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Left Side of Neck
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Right Side of Neck
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Upper Back
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Left Side of Upper Back
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Right Side of Upper Back
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Mid Back
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Left Side of Mid Back
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Right Side of Mid Back
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Low Back
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Left Side of Low Back
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Right Side of Low Back
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Chest
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Abdomen
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Left Arm
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Right Arm
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Left Shoulder
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Right Shoulder
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Left Elbow
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Right Elbow
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Left Wrist
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Right Wrist
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Left Hand
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Right Hand
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Left Leg
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Left Thigh
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Left Calf
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Right Leg
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Right Thigh
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Right Calf
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Left Gluteal
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Right Gluteal
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Left Hip
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Right Hip
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Left Groin
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Right Groin
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Left Knee
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Right Knee
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Left Ankle
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Right Ankle
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Left Foot
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Right Foot
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Sacrum
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Tailbone (coccyx)
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Headaches
Sinus
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Chronic Daily Headache
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Tension
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Migraines
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Headaches
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Cluster
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Rebound
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Other Headaches
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Musculoskeletal
Bone Disease
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Carpal Tunnel Syndrome
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Paget Disease
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Artificial Joints / Special Equipment
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Compartment Syndrome
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Torticollis
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Plantar Fasciitis
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Psoriatic Arthritis
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Temporomandibular Joint Dysfunction
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Dislocation
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Baker's Cyst
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Dupuytren's Contracture
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Gout
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Scleroderma
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Whiplash
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Degenerative Disk Disease
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Fracture
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Recti Diastasis
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Chronic Myofascial Pain Syndrome
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Jaw Pain (TMJD)
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Scoliosis
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Hereditary/Congenital Deformity
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Chronic Fatigue Syndrome
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Strain/Sprain
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Sinus Problems
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Joint Injury
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Spondylolisthesis
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Amyotrophic Lateral Sclerosis (ALS)
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Arthritis
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Fibromyalgia
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Osgood-Schlatter Disease
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Ehlers-Danlos Syndrome
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Muscular Dystrophy
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Ankylosing Spondylitis
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Tendonitis/Bursitis
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Osteomalacia
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Osteoarthritis
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Myasthenia Gravis
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Osteoporosis
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Other Musculoskeletal
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Reproductive
Pregnancy
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Cardiovascular
Cold Hands
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High Blood Pressure
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Cold Feet
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Low Blood Pressure
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Varicose Veins
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Swelling
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Other Cardiovascular
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Skin
Acne
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Eczema
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Psoriasis
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Allergic Dermatosis
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Rash
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Rosacea
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Athletes Foot
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Skin Conditions
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UV Burn
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Bruise Easily
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Chemical Burn
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Hypersensitive Reaction
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Skin Irritations
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Athlete's Foot
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Hypersensitive Reactions
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Melanoma/Carcinoma
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Infectious Skin Conditions
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Melanoma
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Pigmentary Disorder
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Herpes
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Plantar's Wart
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Neurological
Numbness
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Sciatic Pain
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Endocrine
Diabetes
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Blood
Thrombosis/Embolism
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Anemia
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Gastrointestinal
Digestive Conditions
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Miscellaneous
Other Medical Conditions
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Massage Goals
Address Health Issues
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Strength Training
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Alternative Therapy
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Stress Relief
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Balance
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Flexibility
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Improve Fitness
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Increase Well-Being
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Injury Rehabilitation
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Positive Reinforcement
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Massage Frequency
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Other
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Which best describes what you are experiencing
Pain
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Mild
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Getting Worse
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Ache
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Moderate
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Staying the Same
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Tension
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Disabling
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Getting Better
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Discomfort
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Constant
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Imbalance
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Intermittent
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Increases with Activity
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Decreases with Activity
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No Change
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Other
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