Complete this survey to help us assess your knee pain symptoms.The answers you give to the survey below can help ARA experts determine if you might be a candidate for genicular artery embolization (GAE), a leading-edge, non-surgical way to treat knee pain from osteoarthritis.Fill out and submit the following survey and an ARA interventional coordinator will contact you to determine if GAE is right for you. "*" indicates required fields PhoneThis field is for validation purposes and should be left unchanged.Questions about your knee pain:Questions about your knee pain:NoYesDo you have pain in either or both of your knees?Do you have swelling or redness around your knee?Does your knee pain worsen with movement, such as walking, climbing stairs, or squatting?Does knee pain wake you up at night?Are you avoiding doing certain activities because of knee pain?Does your knee pain worsen throughout the day?Have you been told by a medical practitioner that you need a knee replacement?Have you been diagnosed with osteoarthritis of the knee?ScoreSubmit your scores to ARA Diagnostic ImagingConsent to Submit ScoreIf you replied “yes” to any of the above questions, you could benefit from GAE. Please enter the information below to submit your survey and we will follow up with you about next steps. Yes, I consent to submit my scores Name* First Last Age*Date of birth*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Phone*Have you had treatment for your knee pain?* Yes No Which of the following treatments have you had?Pain medication* Yes No Physical therapy* Yes No Knee brace* Yes No Cortisone (steroid) injections* Yes No Knee gel shots* Yes No Knee surgery* Yes No What type of surgery?*Other treatments not listed* Yes No Other type of treatment*