Please complete this form before your first visit. It takes about 10 minutes and helps us prepare for your appointment.
I accept texts/e-newsletters with office announcements and closures
INFORMED CONSENT TO INITIATE CARE
Complete one set of forms per family member.
• I understand that chiropractic care involves manual adjustments of the spine and extremities, and that this care may occasionally cause temporary soreness or discomfort.
• I understand that chiropractic physicians detect and correct vertebral subluxation to restore and maintain optimum nervous system health.
• I understand that the purpose of chiropractic care is not to cure or treat any specific disease or condition.
• I understand that results vary by individual and no guarantee has been made regarding the outcome of my care.
• I understand that I have the right to refuse chiropractic care at any time, for any reason.
Please print your name, sign, and date below.
I wish to initiate care at this office. I have read and understand the Informed Consent to Initiate Care and agree to all terms.*
