Fill out the Form and click "submit."

* Most fields must be filled out for best answer

Name       *   City          *    State         *

email       * e.g.. joesmith@hotmail.com

Age         *  Gender    *  

   

CHIEF COMPLAINTS

 

History with date and mode of onset *

How did it happen? If you don't know say so.*

 

 

What movement or circumstance makes the pain worse?  (Can you mechanically reproduce or increase, the signs or symptoms by movement of a body part?)* If you don't know say "don't know."

e.g.. Touching my ear to my left shoulder causes pain in my left hand.


What movement or circumstance makes the pain better?   (Can you mechanically decrease the signs or symptoms by movement of a body part?)*


e.g. lying down, not moving, resting

 

Does the pain radiate?        *

Where does it radiate?       Does pain or any sensation travel down an arm or leg?

Do you experience numbness in your hands or feet? 

Does food affect your pain? *

 

Other                                                                    

 

 

A visitor may post any question they wish, however, the posted answers to those questions are not a diagnosis, prognosis or treatment recommendation. The posted answers do not in any way constitute the practice of chiropractic, medicine or any other health care profession. Visitors are expected to consult their own health care provider regarding their specific case.

Link under construction for general questions: Ask the Doctor