Initial Chiropractic Assessment (Pain & Injury Visit)
These forms are for patients who are coming in for their first chiropractic appointment or conditioning/rehab assessment.
Patient Entrance Form Pain Pattern Form Neck Disability Index Medication/Supplement FormInitial Functional Medicine Consultation (Individual Wellness Program)
These forms are for patients who are coming in for nutritional and/or general health consultations. Please bring to your appointment any nutritional supplements you are taking at present as well as any that you have recently stopped. This includes any vitamins, minerals, antioxidants, essential fatty acids (i.e. fish oil), probiotics (healthy intestinal bacteria), protein powders, green foods, or powdered foods. Also bring a complete list of any medications you are taking with exact dosages and frequency taken (bring the bottles if this is easier).
2_AMI Part 1 2b AMI Family History 2_AMI Part 3 Medical Symptoms QuestionnaireAdult Toxin Exposure
Biofeedback / Neurofeedback
This form is for patients who are coming in for their first biofeedback / neurofeedback appointment.
Neurofeedback Questionnaire