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Hi there, please fill out this form to help determine your suggested membership level.
10
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1
Do you make an appointment twice per month or more?
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NO
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2
Do you book your appointments for multiple weeks or months in advance?
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NO
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3
Do you use ancillary services other than chiropractic care? (e.g. massage, nutritionist, muscle testing, FSM, low level laser, kinesio-taping, etc.)
YES
NO
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4
Do you use the far-infrared sauna and/or red-light therapy?
YES
NO
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5
Do you order routine blood labs or functional medicine tests through our office?
YES
NO
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6
Do you order supplements through Fullscript?
YES
NO
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7
Do you email questions to your practitioner?
YES
NO
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8
If female, are you pregnant or do you plan to become pregnant?
YES
NO
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9
Are there any children under the age of 5 as patients?
YES
NO
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10
Do you text your practitioner, request appointment times outside of regular business hours, or require unique accommodations?
YES
NO
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11
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