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MR Guided Focused Ultrasound
Request an Appointment
2022-07-05T14:13:54-06:00
East Campus
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MRGFUS Appt Request
Name
*
First
Last
Phone
*
Email
*
Describe the impact your hand shaking has on your daily life?
*
MILD
MODERATE
SEVERE
Have you been diagnosed with essential tremor?
*
YES
NO
Have you ever taken prescribed medications for your hand tremor?
*
YES
NO
How soon are you seeking treatment for your essential tremor?
*
AS SOON AS POSSIBLE
IN NEXT 3 MONTHS
SOMETIME IN THE FUTURE
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