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PROGRESS EXAM
QUESTIONNAIRE #3

Our goal is to offer the highest quality care possible. It is common to notice positive changes in your overall health and well-being as your nervous system function begins to improve. Please help us by responding to the following questions about your wellness care in our office.

In your own words what CHANGES have you noticed since beginning care?

Do you find it easier to:
What have you noticed as far as your health and healing?
Do you understand why chiropractic care is important for children?
Do you understand how daily stress affects your health?
Do you understand how chiropractic care helps improve your immune system and reduce physiological stress?
Would you like a gift certificate for a family or friend?

Thanks for submitting! We have received it.

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