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This document serves as an intake packet for patients visiting Kapeikis Chiropractic & Massage for massage care only. It includes personal information, consent to participate, account information,
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How to fill out kapeikis chiropractic massage intake
How to fill out Kapeikis Chiropractic & Massage Intake Packet
01
Start with your personal information: Fill in your name, address, contact number, and email at the top of the form.
02
Provide insurance details: Enter your insurance provider's name, policy number, and any other required information.
03
Fill out medical history: Answer questions about your medical history, including past surgeries, current medications, and any existing health conditions.
04
Specify the reason for your visit: Clearly state the reason you are seeking chiropractic and massage therapy.
05
Complete the consent section: Read and sign the consent for treatment section, ensuring you understand your rights and the nature of the treatment.
06
Review and double-check: Go through the entire form to make sure all information is accurate and complete.
07
Submit the packet: Hand in the completed intake packet at the reception or scan and email it to the office as instructed.
Who needs Kapeikis Chiropractic & Massage Intake Packet?
01
Individuals seeking chiropractic care for pain management or musculoskeletal issues.
02
Patients looking for massage therapy to relieve tension and stress.
03
New patients who require assessment and treatment plans.
04
Anyone with a medical history that may impact their treatment approach.
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What is Kapeikis Chiropractic & Massage Intake Packet?
The Kapeikis Chiropractic & Massage Intake Packet is a form that new patients fill out to provide essential personal and medical information necessary for their chiropractic and massage therapy treatment.
Who is required to file Kapeikis Chiropractic & Massage Intake Packet?
All new patients seeking chiropractic or massage therapy services at Kapeikis Chiropractic & Massage are required to fill out the Intake Packet before their first appointment.
How to fill out Kapeikis Chiropractic & Massage Intake Packet?
To fill out the Kapeikis Chiropractic & Massage Intake Packet, patients should carefully read each question, provide accurate and detailed information about their health history, current symptoms, and any medications they are taking.
What is the purpose of Kapeikis Chiropractic & Massage Intake Packet?
The purpose of the Kapeikis Chiropractic & Massage Intake Packet is to gather comprehensive information about a patient's medical history and symptoms, enabling the practitioner to create a personalized treatment plan.
What information must be reported on Kapeikis Chiropractic & Massage Intake Packet?
Patients must report personal information such as their name, contact details, and insurance information, as well as detailed health history including any past injuries, surgeries, current medications, allergies, and descriptions of their current health concerns.
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