HIPAA Privacy Practices
This office utilizes an "Open Adjusting" environment for ongoing patient care. Open Adjusting involves several patients being seen in the same adjusting room at the same time. The use of this format is intended to make your experience with our office more efficient and prodcutive as well as enhance your access to quality health care and health information. If you choose not to be adjusted in an Open Adjusting environment, other arrangements will be made for you.
Informed Consent to Chiropractic Treatment and Care
I hereby request and consent to the performance of procedures which are within the scopeof practice of chiropractic including, but not limited to, chiropractic adjustments and various modes of physical therapy, on me by the Doctor of Chiropractic named above and/or other licensed Doctors of Chiropractic who now or in the future can treat me.
I understand that results are not guaranteed. I understand and am informed that there are some risks to chiropractic treatment, including, but not limited to fractures, disc injuries, strokes, dislocations, and sprains. I have read the above consent. I have also had an opportunity to ask questions about its content, and by signing below, I agree to the above-named procedures. I intent this consent form to cover the course of treatment for my present condition.