Patient Intake Form
Hello and welcome to Djuric Chiropractic. We are happy to have you as a patient!
-Once you get to the portion of the paperwork with an image of a body, please select the region of your primary complaint first because the image will not allow you to select multiple areas that are not adjoining.
-Answer the questions based on the primary complaint.
-If you have additional complaints, at the very bottom of the paperwork page, select yes to the "do you have an additional condition" question.
-You will be prompted to answer the same questions again where you can select a different region.