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Get and Sign Chiropractic X Ray Report Template  Form

Get and Sign Xray Form Chiropractic

Create a custom xray form chiropractic 0 that meets your industry’s specifications.

With your office directly. Our phone is 510 -FAX this form to us at (510) 780-4511. -A $25.00 fee may be charged if your patient fails to show up for their appointment. _____Bill Doctor’s credit card on file ______Patient to pay on day of service Plain Film X-ray________ Digital X-ray (CD for computer) ___________ Request for DACBR report__________ Note: Billed separately by mail Cervical X rays ____LAT, APOM, APLC (3 views) ____Cervical obliques (2 views) ____Cervical Flex/Ext (2...
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All right so we're here with Jeff and Jeff is a first-time patient at finish line wellness, and so we're going to go through a typical day one with Jeff and do a history first to start off, so Jeff has come in, and he's giving me some info here his intake form set some stuff to go off of in questions to ask him, so we're start first to do on your intake form you talked about that you have some hip issues going on tell us a little about when then what did that start for you, it started probably when I was in college late college I was a lot heavier than I am right now it was waved up to 75 to 80, and now I'm about to 15 to 20 and so just all that weight was coming down and affecting well everything lower body especially the hip, so I started developed like this nerve pain would eventually make my toes numb and from there it is also like radiators like some lower back pain and just messed up total body alignment, so that's pretty much what it's gotten a lot better since I dropped the wei

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