Contact & Locations Contact us directly or fill in the form below and we will reach out within 24h (928) 316-6645 injuryrestoreclinic@gmail.com Name * First Name Last Name What is the name and location of your practice? Required for Providers Email * Phone (###) ### #### Message How did your pain or injury start? For example: a certain event, progressively without event,... Required for Patients How long have you had this pain or injury? Required for Patients Where is your pain or injury located? For example: front of the left knee, outside of the right ankle,... Required for Patients Do you experience swelling at the location of your pain or injury? Required for Patients When do you experience pain? For example: constantly, intermittent, during certain movements,.. Required for Patients Have you had prior imaging? For example: X-ray,.. Required for Patients Have you had prior treatments for this pain or injury? For example: medication, operation,... Required for Patients What activities or sport do you do and how many times per week? Thank you for contacting us! We will be in touch soon.