Just Breathe Healing

Just Breathe Healing offers our patient form(s) online so you can complete it in the convenience of your own home or office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download.
• Download the necessary form(s), print it out and fill in the required information.
• Fax us your printed and completed form(s) or bring it with you to your appointment.

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New Patient Health History Form - Required

This let’s us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download Forms:

• New Patient Intake Form
• Comprehensive Symptom Survey Pg 1
  
• Comprehensive Symptom Survey Pg 2

Additional Details

COMPREHENSIVE SYMPTOM SURVEY

A very in-depth (121 point questionnaire) assessment and discussion that provides a more profound understanding of the physiological, behavioral and cognitive functions of the patient, thus enabling us to tailor a very personalized treatment plan that addresses all aspects (mental, emotional, physical and spiritual) of one’s life.

Duration approx. 20 min.

Chiropractic care can offer the missing pieces to achieve your body's wellness potential.

Need More Information About your First Visit?

COMPREHENSIVE INITIAL EVALUATION

At the initial contact with the patient, we take a full history including birth, childhood years, injuries, traumas and continuing with mental, emotional and spiritual history. Next we assess the body from an holistic point of view by using palpatory (feeling) skills to listen to the patient's living anatomy, the texture and motion of tissues, structural build up. As needed, we test to identify nutritional needs, metabolic efficiency, neuro-endocrine potential, toxic accumulations and function of different organ systems (i.e. cardio-vascular, digestive, etc.)

Then we put together all the information and design a treatment plan together with you that will not only get rid of the symptoms but will help you move away from dis-ease and move toward the state of vibrant health as you build your whole body...Mind, Body, Spirit... of Health.

Duration approx. 1.5 hr.