Contact Drop us a line. Contact InfraRx™ Phone (844) 463-7279 Email info@infrarx.com Name First Last Email Leave us a message NameThis field is for validation purposes and should be left unchanged. Patient Survey Step 1 of 4 25% Patient's Name(Required) First Last Doctor's Name(Required) First Last Which body part(s) are you using InfraRx to treat?(Required) Back Neck Shoulder Elbow Hip Knee Hand/Wrist Foot/Ankle Other Select All What is your pain level without / before using InfraRx?0123456789100= no pain 10= Excruciating painWhat is your pain level while / after using InfraRx?0123456789100= no pain 10= Excruciating painBy what percent is your pain reduced when using InfraRx?0123456789100= no difference 10= totally relieves pain Are you being prescribed pain medication for your condition? Yes No Have you been taking less pain medication since using InfraRx? Yes No Has InfraRx improved your mobility and functionality? Yes No Did you use InfraRx once a day for 30-45 minutes, as recommended? Yes No Was InfraRx easy to use? Yes No Additional Comments
