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AI Sprint: Freedom from Back Pain Assessment

Full Name

*

Email Address

*

WhatsApp / Mobile Number

*

Primary Role / Activity

*

Duration of Back Pain

*

A

Acute (under 12 weeks)

B

Chronic (12+ weeks)

Pain Intensity Score

*

0

1

2

3

4

5

6

7

8

9

10

Daily Impact

*

Limits daily activities

Limits work

Limits sleep

Tried Solutions

*

Physical therapy

Chiropractic care

Surgery

Nothing yet

How familiar are you with AI?

*

A

Beginner

B

Intermediate

C

Advanced

What are your primary goals for this AI Sprint workshop?

*

Willingness to Commit

*

A

60-min Sprint

B

90-min Sprint

C

3-day Workshop

D

Yes/No (General interest)