So That We Can Serve Your SPECIFIC Needs, Please Fill Out This Form (it only takes 30 Seconds) And Tell Us EXACTLY How You Want Us To Help YOU… The more we know about you, the better we can help you.
What Concerns You The Most That Makes You Want To Consider Chiropractic Care?
Not Knowing What's Wrong
Fear of Not Being Able to Stay Active
My body doesn't recover from activity like it used to
I've tried other treatments but haven't found lasting results
I want to improve my performance in fitness, sports, or recreational activities
Concerns at No Sign of Improvement
Want to Avoid Pain Killers & Medications
The Risk of Needing Dangerous Surgery
I want to address the root cause of my discomfort, not just mask symptoms
I want to be proactive about my health and prevent future problems
I'm missing out on social activities or family events
My sleep quality is suffering, affecting other areas of my life
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How Long Have You Suffered or Worried?
Haven't - This is Prevention (Not Cure)
A Few Days
1-2 Weeks
2-4 Weeks
1-3 Months
Long Enough (4+ Months)
Seems Like Too Long (Years)
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Main Goal Of Using Our Specialist Service
Return to my favorite activities (hiking, gym, sports) without limitations
Build strength and resilience to stay active as I age
Learn proper movement patterns and self-care strategies
Understand the root cause of my issue and how to prevent it from recurring
Find a long-term solution, not just temporary relief
Address the issue now before it becomes more limiting
Reduce dependency on medications or avoid surgery
Find Out What's Wrong
Maintain my active lifestyle and independence long-term
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Where does it hurt?
Back
Low Back
Knee
Leg
Neck/Shoulder
Foot/Ankle
Hip
Pelvic Region
Arm/Wrist/Elbow
Head/Jaw
Headache/Migraine
Muscle Injury From Sports/Exercise
Not Sure Where It's Coming From
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