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Jeff L. Chapter, MD, DAB APM Bryan Berman, DC David E. Farmland, MD, DAB APM Veronica Kings, PAC Mark E. Larking, MD, DAB APM Audrey Disney, ARN PBC PATIENT INTAKE FORM NAME: TODAYS DATE: FIRST MIDDLE

How to fill out bryan boerjan dc

Point by point instructions on how to fill out Bryan Boerjan DC:

1. Provide your personal information: Begin by entering your full name, date of birth, and contact details such as phone number and email address. Make sure to double-check the accuracy of this information before moving on to the next step.
2. Indicate your current address: Fill in your current residential address, including the street name, city, state, and zip code. If you have a different mailing address, where you would like any correspondence to be sent, provide that information as well.
3. Specify your citizenship status: Select your citizenship status from the options available. This may include options such as "U.S. citizen," "Permanent resident," or "Non-U.S. citizen."
4. Provide employment details: In this section, you will need to provide information about your current employment status. This may include your job title, the name of your employer, and their contact information.
5. Fill out the medical history section: Bryan Boerjan DC form may include a section where you will need to disclose your medical history. Provide accurate and complete information to ensure proper evaluation and treatment.
6. Consent to treatment: Review and acknowledge the consent to treatment section, where you will need to agree to the terms and conditions of receiving chiropractic services from Bryan Boerjan DC.
7. Sign the form: Finally, carefully read through the entire form and sign it to validate all the information provided. Ensure that you sign and date in the appropriate sections as instructed.

Who needs Bryan Boerjan DC?

1. Individuals seeking chiropractic treatment: Bryan Boerjan DC is a chiropractor, and his services are beneficial for individuals experiencing musculoskeletal conditions, back pain, neck pain, headaches, and other related problems.
2. Those in need of alternative and holistic healthcare: If you prefer a natural approach to healthcare, Bryan Boerjan DC may be a suitable option. Chiropractic care focuses on improving overall wellness by addressing the spine and nervous system.
3. Patients looking for personalized treatment plans: Bryan Boerjan DC is known for his patient-centered approach. He tailors treatment plans based on each individual's specific needs, ensuring a customized and effective course of action.
4. Individuals seeking pain management without medication: Chiropractic care can often provide relief from pain and discomfort without relying on heavy medication. If you prefer a non-pharmaceutical approach to managing your symptoms, Bryan Boerjan DC may be a good fit for you.

Overall, anyone in need of chiropractic care, seeking holistic wellness solutions, and looking for an individualized treatment experience can benefit from Bryan Boerjan DC's services.

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