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GORDON CHIROPRACTIC Family Health and Wellness Center 3212 N 13th St. Terre Haute IN 47804 812 460-1400 Phone www. gordon-chiro. com Please complete this application for care to help us determine if chiropractic care is right for you. In the case that the patient is a minor I as the guardian am stating that I agree for Gordon Chiropractic to provide all services of care to my minor child/children. Patient/Guardian Signature Date INTAKE FORM Aug-2014 page 1 of 6 Throughout life stressed and...
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How to fill out Gordon Chiropractic:

01
Start by gathering all necessary paperwork, such as your medical history, insurance information, and any specific forms provided by Gordon Chiropractic.
02
Arrive at the scheduled appointment time and check-in with the receptionist. They will likely ask for your name, appointment time, and possibly insurance information.
03
Once you are called back, you may be asked to provide more detailed information about your medical history, including any previous injuries or conditions you may have had. This helps the chiropractor understand your specific needs and design a personalized treatment plan.
04
During the consultation, the chiropractor will discuss your symptoms or concerns in more depth. Be open and honest about any pain, discomfort, or limitations you are experiencing.
05
Depending on your condition, the chiropractor may perform a physical examination, which may involve assessing your range of motion, posture, and flexibility.
06
The chiropractor may recommend further diagnostic tests, such as X-rays or MRI scans, to get a better understanding of your condition.
07
After evaluating your medical history, examination findings, and possibly diagnostic test results, the chiropractor will develop a treatment plan tailored to your specific needs. They will explain the recommended course of action, including the number of sessions anticipated and any other therapies involved.
08
If you agree with the treatment plan, you can proceed with scheduling your appointments. It is essential to follow the recommended treatment schedule to maximize the potential benefits of chiropractic care.

Who needs Gordon Chiropractic:

01
Individuals experiencing acute or chronic pain: People suffering from back pain, neck pain, headaches, joint pain, or other musculoskeletal issues can benefit from the services provided by Gordon Chiropractic.
02
Those seeking natural and non-invasive treatment options: Chiropractic care focuses on utilizing manual adjustments, therapeutic exercises, and other drug-free techniques to promote healing and pain relief.
03
Individuals interested in preventative care and wellness: Chiropractic care is not just for those in pain. It can also help prevent injuries and enhance overall well-being by improving posture, mobility, and spinal health.
04
Athletes and active individuals: Athletes and those leading an active lifestyle often put strain on their bodies. Chiropractic care can help optimize performance, prevent injuries, and aid in recovery.
05
Individuals with specific conditions: Some people with conditions like arthritis, sciatica, or fibromyalgia find relief and improved function through chiropractic care.
Remember, it is always advisable to consult with a healthcare professional before starting any new treatment or therapy, including chiropractic care, to ensure it is suitable for your individual needs.
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Gordon Chiropractic is a healthcare provider specializing in chiropractic care.
Individuals or entities providing chiropractic services are required to file Gordon Chiropractic.
Gordon Chiropractic can be filled out by providing information about the services, charges, and patient details.
The purpose of Gordon Chiropractic is to document and report chiropractic services provided to patients.
Information such as patient name, date of service, type of service, charges, and payment details must be reported on Gordon Chiropractic.
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