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Check If You Qualify for BNAP Treatment

Complete this short screening assessment to help our physiotherapy team understand your condition and determine whether BNAP therapy is the right next step for your recovery.

Gender
Male
Female
Prefer not to say
How did you hear about the BNAP Programme?
Employer
Doctor
Friend/ Family member
Social media
Therapist
Other
Language
English
IsiZulu
Afrikaans
IsiXosa
Medical Aid
GEMS
BestMed
Polmed
Wooltru
Compcare
Massmart
OMSMAF
Tiger Brands
SABMAS
Profmed
Area of concern
Back
Neck
Back & Neck
How long have you been struggling with back/ neck pain
0-3 months
3-6 months
> 6 months
Other
How many of your usual daily activities do you struggle to do now because of this condition?
0
1-3 activities
> 3 activities
Have you accessed any medical care/ investigations for this condition in the last 3 months?
Yes
No
Please specify
X-rays/ scans/ ultrasound
GP
Specialist
Physio/ Chiro/ other
Medication
Surgery
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