This form will allow your chiropractor’s team to open your file. Please answer the questions as accurately as you can. If your chiropractor feels the need to explore a question with you, he will do so during the evaluation.

If you fill out this form, you agree to send us the information in order to attach it to your health file.

In case of doubt or insecurity to answer the question, do not answer and your chiropractor will ask you the question during your examination.