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Cornell Clinic of Chiropractic Page 1 of 9ACCIDENT INTAKE FORMS Please print clearly! Patients Last Name First Name Nickname Sex M F Social Security Number / / Driver's License # Date of Birth / /
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01
Start by scheduling an appointment with Corsello Clinic of Chiropractic.
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Arrive at the clinic on time for your scheduled appointment.
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Fill out the necessary registration form provided by the clinic.
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Provide your personal information and medical history accurately and completely.
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Prioritize any existing or previous conditions or injuries that you want the chiropractor to be aware of.
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Be open and honest about any discomfort or pain you are experiencing.
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Follow any additional instructions or recommendations given by the chiropractor.
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Pay for the services rendered according to the clinic's payment policies.
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Schedule any follow-up appointments that may be necessary for your treatment plan.
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Keep track of any improvements or changes you experience after receiving chiropractic care.

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Individuals suffering from back, neck, or joint pain.
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Anyone seeking to improve their overall well-being and body alignment.
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Corsello Clinic of Chiropractic is a healthcare facility that specializes in providing chiropractic services.
Corsello Clinic of Chiropractic is required to file by the healthcare providers and chiropractors working at the clinic.
Corsello Clinic of Chiropractic can be filled out by providing information about the clinic's services, staff, financials, and any other required details.
The purpose of Corsello Clinic of Chiropractic is to maintain accurate records of the clinic's operations and services.
Information such as patient records, services provided, financial transactions, and staff credentials must be reported on Corsello Clinic of Chiropractic.
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