Thank you for completing this questionnaire before booking your appointment for a possible joint injection.

You have been asked to complete this form because the clinician who assessed you felt that joint injection may be beneficial for your symptoms.

The information will be reviewed alongside your medical records at your face-to-face appointment. The clinician will ask any additional questions, examine the joint, confirm that a joint injection is safe and appropriate, and obtain your formal consent for the procedure.

PLEASE NOTE: COMPLETING THIS QUESTIONNAIRE AND ATTENDING A FACE-TO-FACE APPOINTMENT DOES NOT GUARANTEE THAT A JOINT INJECTION WILL BE GIVEN. THE CLINICIAN WILL MAKE THE FINAL DECISION AT YOUR APPOINTMENT AND IS ENTITLED TO DECLINE TO GIVE A JOINT INJECTION IF THEY CONSIDER IT IS NOT APPROPRIATE OR SAFE.

Thank you for taking the time to complete this form. Once you have submitted your responses, you will be provided with information on how to book an appointment.