New Patient Chiropractic Visit in Cambridge, OH

What to Expect at Your First Chiropractic Visit

Complete three steps with completion.

Our Thorough Foundational Eval & Care includes:

Doctor Consult
Spinal exam
Paraspinal Thermography Scan
Adjustment as necessary
Therapy Chair (5 min.)

or

or

Please register below for your discounted Foundational Chiropractic Evaluation. Thank you!

I, the undersigned, attest that I have completed the Orientation, and that understanding is implicit to the Orientation discount on my initial visit. (Sign w/ mouse or touchscreen)

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Who referred you to our office?

First name

Last name

Birthday

Month

Day

Year

Age

Patient sex

Male

Female

Occupation

Email

Phone

I accept texts/e-newsletters with announcements, appointment confirmations, and office closures.

Multi-line address

Country/Region

Address

City

Zip / Postal code

1. How do we describe our body's natural state of being? Circle one or all that apply

Everybody was designed to be sick and dis-ordered.

Well-ordered and in harmony

2. Can you see "order" in the body's function?

No--you cannot observe order.

Yes, it is observable in every heart beat and the life and growth of an infant.

3. What is it that controls the rest of your body's tissues, organs, and glands?

My endocrine/hormone system

My brain and spinal cord

My heart

4. The neuro-spinal system includes (select all that apply)

My brain

My spinal cord

My vertebral bones protecting the nerves.

Food and medicines

5. Are the functions of the neuro-spinal system...

Automatic and mostly outside consciousness

Fully under the control of my every thought

6. What blocks the neural information traveling through the spine?

Constipation

A blocked artery

A vertebral bone out of place or "malpositioned"

7. In the safety-pin model of a vertebral malposition, a closed pin shows

A closed off nervous system all blocked up

A fully connected circuit of neural messages between brain cells and body cells

8. What happens when a vertebral malposition occurs

Neuro-spinal interference

Automatic pain

9. Are vertebral malpositions and the neuro-spinal interference

Uncommon and occur only with lifting injuries

Common due to modern stressors

10. The most common stressor causing neuro-spinal interference

Bad posture

Angry drivers in traffic

Toxic load from harmful chemicals in the water, air, and food.

11. What is the most sensitive tissue to environmental toxins?

My intestines

Brain, spine and neural tissues

12. How do toxins make vertebral bones more likely to go out of place or malposition?

Getting pill bottles thrown at me by people who are frustrated with pills.

A discoordination of the nerves that normally would control muscles that pull on the vertebral bones.

13. Better neuro-spinal connections make better _____________ families and community.

14. What does brighter neuro-spinal connections mean for my brain and body cells?

Higher order and harmony

Disorder and dysfunction

15. If I complete this orientation, my first visit fee for my doctor consultation, spinal scan, and first adjustment is...

The normal fee of $157

The reduced fee of $90

16. The Foundational Family discount is...

First household family member at $90/person, second at $45/person, third and all household, family members after the first two are FREE.

All family members are $90/person.

I understand the Honor Box is no longer accepting new participants.

Yes

17. Membership discounts for wellness spinal checks are available with membership discounts provided that I...

Complete the Spinal Wellness Orientation.

Complete my Foundational Care Plan given to me at my second visit.

All the above.

18. Access to walk-in hours starts only after completing my scheduled Foundational Care Plan prescribed for me at my 2nd visit.

True

False

Stress causes vertebral mal-position because it impairs muscles that normally would hold a vertebral bone in place. Which of the three types of stress would be your biggest factor?

Questions, Feedback, etc.

500px-Eo_circle_orange_number-3.svg.webp

Schedule

or

Call