Get Working Copy Of Chiro Intake.doc

Filling out the WORKING COPY OF CHIRO INTAKE.doc online is a crucial step in ensuring you receive the appropriate chiropractic care tailored to your needs. This guide provides clear, step-by-step instructions for completing each section of the form accurately.

Follow the steps to successfully complete your chiropractic intake form.

1. Press the 'Get Form' button to access the WORKING COPY OF CHIRO INTAKE.doc online.
2. Begin filling out your personal information, including your full name, gender, date of birth, and age. Make sure to provide your Care Card number for identification purposes.
3. Complete your contact details, including your home phone, work phone, and cell phone. Indicate whether you would like to receive appointment reminders via email or text.
4. Provide information about your medical doctor and how you were referred to the clinic. If applicable, state if this is an ICBC claim and fill out the details including the claim number and adjustor’s contact information.
5. Write down the reason for your visit and any previous treatments you have tried. Specify any relevant information regarding your injury, including how it occurred and its severity.
6. Indicate your current health history, including any previous motor vehicle, work, or sports injuries. Examine any significant medical conditions or surgeries you have had.
7. Complete the section on current medications, allergies, and family history of relevant health issues.
8. Finish any remaining health history checks and answer the questions regarding your lifestyle habits and sleep patterns.
9. Sign the assignment of medical services plan benefits and informed consent sections as appropriate, ensuring you understand your rights and responsibilities.
10. Review the filled-out form for accuracy. Once completed, you can download, save, print, or share the document to finalize your submission.

Start completing your WORKING COPY OF CHIRO INTAKE.doc online today to ensure timely and effective chiropractic care.