D3 Recommendations Dr. Nathalie

YOUR OVERALL HEALTH RESULTS

AND YOUR DOCTOR'S RECOMMENDATIONS FOR YOUR CHIROPRACTIC CARE
Name

First NameLast Name
Email
example@example.com
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
MAIN COMPLAINTS:
1
2
3
MAGIC WANDS:
1
2
3
YOUR SPINE HEALTH STATUS:
Anterior head carriage
Posterior throracic translation
Cervical lordosis
Lumbar lordosis
Phase of vertebral subluxation degeneration (Cervical spine)
Phase of vertebral subluxation degeneration (Lumbar spine)
How long have your subluxations been present?
NERVOUS SYSTEM HEALTH STATUS:
Neuro scans overall CoreScore results
Heart Rate Variability HRV score
Muscle scan score
Thermal scan score
Total energy score
DIAGNOSIS AND CLINICAL IMPRESSION
PROGNOSIS:
CARE PLAN:
TYPE OF CARE SELECTED:
BEST RECOMMENDATION TO ACHIEVEN YOUR GOAL:
PLAN OF MANAGEMENT / TREATMENT PLAN
ADMIN:
Enter in FUFG Campaign:
SANTECHIROPRACTIC.COM
DR. NATHALIE BEAUCHAMP, B.SC., D.C.
1-1224 PROM. PLACE D'ORLEANS DR. OTTAWA ON K1C 7K3
613-837-2883
Should be Empty:

YOUR OVERALL HEALTH RESULTS