Progress check 1

Please help us to serve you better by responding to the following questions about your progress.

Name

First Name

Last Name

1. What were your initial reasons for consulting us?

2. What changes have you noticed since beginning Chiropractic care?

3. Is your general movement easier?

5. Are you happy with your overall care at this stage?

5. Would you say you are improving at the speed you expected, slower than you expected, or faster than you expected?

You expected

Slower than you expected

Faster than you expected

6. Would you consider writing us a review?

7. Would you like any additional information on our Massage, 8WW, Functional Fitness, Supplements or Health Workshops?

8. Is there anyone you would like a New Patient voucher for? This allows them a free consultation with the Chiropractor including a spine and posture examination

9.Would you like to receive health related emails from us in the future?

Consent

A Chiropractic adjustment is considered to be a safe and effective form of therapy for spinal conditions i.e. vertebral subluxation. A thorough examination, with or without x-rays has been performed to minimize any risk to you. If you have any questions about this, please ask your practitioner.

I have read the above statement and therefore consent to ongoing spinal adjustive chiropractic treatment

Date

YYYY

Start the process →

Progress check 1

Your health awaits.