PATIENT APPLICATION FORM

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Welcome! This is what you can "expect" in your upcoming visit's.

INTAKE APPLICATION

Please complete this intake application so we have an understanding of your past and current health situation. Please complete the following information as thoroughly as possible so the doctor can let you know if you are a case we can accept. Please understand that not all cases are a fit for the care that we provide, therefore we must examine all information disclosed to provide the safest and most effective care for you. Please feel free to ask any questions if you need assistance.

CONSULTATION: You will meet the doctor and discuss your health concerns. We pride ourselves in assisting our patients to achieve their highest level of health through our spinal and postural corrective programs. Our approach is very unique and advanced from other Chiropractic & Rehabilitative programs. This allows our patients to achieve far superior results compared to most other systems.

EXAMINATION: We will conduct a thorough examination to locate the cause of your problem and determine if you are a candidate for chiropractic care. This includes a computerized assessment to see how well your nervous system is communicating with your body. The assessment will include rolling neurothermography (which evaluates nerve function and balance), surface electromyography (which evaluates muscle function and balance), and a heart rate variablity scan. The doctor may also need additional procedures, such as x-rays.

RADIOGRAPHIC EXAMINATION: X-Rays may be necessary to determine the severity of your condition. If your doctor needs additional testing such as digital spinal X-Rays, this will be scheduled on a second and individual visit.

REPORT OF FINDINGS: During your second and third visits, the doctor will explain the results of your examination. If we think that we can help you, we will recommend a schedule of care created just for you. During this time we will also explain our financial options and policies.

SPECIAL APPOINTMENT: We find that when patients are empowered to help themselves, they respond faster to care and remain healthier longer. If we decide to accept your case part of your care involves an opportunity to attend our SPECIAL APPOINTMENT entitled "Health and Healing: The inside-out approach."

Please complete the following information as thoroughly as possible so the doctor can let you know if you are a case we can accept. Please understand that not all cases are a fit for the care that we provide, therefore we must examine all information disclosed to provide the safest and most effective care for you. Please feel free to ask any questions if you need assistance.

We look forward to serving you!