As with all forms, in my opinion, only so much info can be gathered by what they write. Make sure you sit and ask your patient more follow up questions that may relate to his/her reason for seeing you.
Chiropractic case history
KATZ CHIROPRACTIC & REHABILITATION CLINIC
2727 Pine Street, Unit 1, Boulder, Co 80302
Office: 303-938-9070 ~ Fax: 303-938-8170
CHIROPRACTIC CASE HISTORY
Date: _____________Name_______________________________________________M______F______ Date of Birth_______________
Have you ever received Chiropractic Care? Y_____N_____ If . . .
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