Follow the steps to complete your exam form online.

1. Click the ‘Get Form’ button to obtain the form and open it in your selected online editor.
2. Begin by entering the provider or clinic name at the top of the form, followed by the date of your visit, which should be formatted as month/day/year.
3. Next, fill in your full name and date of birth in the designated fields labeled 'Patient' and 'DOB.'
4. Indicate your visit type by checking all applicable boxes: 'NEW PATIENT', 'RE-EVALUATION', 'NEW CONDITION', or 'ROUTINE VISIT'.
5. If this is your first exam or you are noting a new condition, please specify the first date you noticed your symptoms and describe your major complaint.
6. For the subjective pain assessment, mark an 'X' on the diagrams provided in the form where you feel pain. Next to each 'X', indicate the type of pain you are experiencing using the abbreviations provided.
7. Rate your overall pain on a scale from 0 to 10 by circling the number that best describes your pain level.
8. Sign the form in the 'Patient/Legal Guardian Signature' section, and the healthcare provider will sign in their respective section.
9. Continue through the form by filling out any additional sections such as range of motion assessments and muscle tests, ensuring to check applicable entries and provide necessary data.
10. Once all sections are complete, you can save changes, download a copy, print the form for your records, or share it as required.

Complete your exam form online today to ensure your chiropractic care starts swiftly.