rs-rei4 DATE OF BIRTH: I -20 -53 DATE: FaS 17 2 0 19 I. Chief complaint (check all that apply): Other O Spinal Deformity (Scoliosis, Kyphosis, Flatback Syndrome, etc.) O Neck pain Arm: O Pain O Numbness O Weakness O Back pain Leg: O Pain O Numbness O Weakness 2. If recommended, please rate how intere