First Day Form ... Welcome!
NAME *
Address, Town, Zip *
Phone *
Email *
Why do you feel you need chiropractic adjustments? *
Are you already comfortable or somewhat nervous with the idea of having your spine adjusted by Dr. Rick? *
Have you ever been adjusted by a chiropractor before? *
Required
Anything else you want Dr. Rick to know about you or your health or anything? *
When you first start, your "Starting Plan" is something like this: “Get adjusted!”, “Repeat Often!” (every day or 2 or 3 times a week), and give your body the “Time!" to heal, yes, really heal! Once your ups and downs, and good days and bad days are gone you should begin "Maintenance." The purpose of this is to get your adjustments to hold and perhaps reach levels of health that you haven't had in years even. How often do you think you should come to get maintenance adjustments? It's just a guess for now. We won't hold you to it! *
Required
Is there anyone else in your family, like spouses or children or parents that should come to the chiropractor also? We ask this because adjustments can help us be healthy not just treat pain or disease! Plus family is already included on all prepaid monthly plans. No extra charge for them. Really, they are already included. Use the other for comments names etc... *
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