Chiropractic Testimonial Form
Name
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First Name
Last Name
What made you seek chiropractic care?
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How long have you had this condition?
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Did you see and other doctors prior to seeking care here? If so, how long/often?
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Did you take any medications prior to seeing us? If yes, how long/ often?
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If yes to the question above, are you still currently taking the same doses at the same frequency or have you been able to reduce any since your care began here?
Check other therapies that you have tried in the past for this condition:
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Physical therapy
Acupuncture injections
Steroid injections
Massage therapy
Opioids
OTC pain relievers
Yoga
Heat or ice
Other
In what ways has chiropractic care improved your condition? Or what activities can you now do that you were unable to do prior to receiving care?
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Would you recommend chiropractic care to your family or friends?
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What is your favorite part about coming in to see Dr. Kirshner?
Submit
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