Home
What to Expect
About
Services
Why Chiropractic
Service areas
Blog
More
Call today: (801) 642-4199
HEALTH SURVEY
Pleas fill out the following questions
Please Check Any And All Problems Areas Or Conditions You are experiencing:
Health concerns
Headaches
Neck pain
Stressed shoulders
Mid back pain
Low back pain
Scoliosis
Auto Accident
Numbness in hands and feet
Sports injury
Loss of energy
Stomach issues
Asthma
Physical stress
Joint pain
Poor posture
Stiffness
Wrist pain
Muscle spasms
Arm pain
Tight sore muscles
leg/hip pain
Other
DO NOT CONTINUE PAST THIS POINT
Screener
Marc
Courtney
Mitch
Sammy
Item 1
arrow&v
Appointment date
Event
Appointment time
Submit
end time
Remember… Your Health Outcomes Are Based On Your Health Choices
Please hand the Ipad back to one of our assistants for you free health assessment.
