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Dr. Jodi Cooley Dr. Michael Fisher Dr. Michelle Adkins 136 Mill Street, Suite 120 Ghana, Ohio 43230PATIENT INTAKE PATIENT INFORMATION Patient Name: ___Employer/School: ______Occupation: ___Address:
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Creekside Chiropractic Center home is a wellness center that offers chiropractic services.
Patients who receive chiropractic care at Creekside Chiropractic Center are required to file their personal information.
Patients can fill out the necessary information on the intake forms provided by Creekside Chiropractic Center.
The purpose of Creekside Chiropractic Center home is to maintain accurate records of patients' health history and treatment plans.
Patients must report their personal information, medical history, and current health concerns.
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