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New Patient Forms
Chiropractic Visit Forms:
Click the appropriate form to complete:
- Adult Health History Form
- 7-17 Years Health History Form
- 0-6 Years Health History Form
- Existing Patient Re-exam Health Questionnaire
*Please note, if you are an existing patient but have a new injury or have not visited our clinic in 90 days, you must complete our "Existing Patient Re-exam" form. This helps us to monitor any changes in your health.
Heal the body from the inside out.
Some people assume that chiropractors “just crack joints” and only fix neck or back pain. But your body is an integrated system of nerves, cells, and chemicals. If one aspect is out of balance, it can wreak havoc on the body. At Brown Family Chiropractic, we are also trained to provide nutritional counseling to help the body heal, reduce inflammation, reduce pain, improve digestion, improve nutrient absorption and overall wellness in the body.
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Nutritional Care to Reveal Your Natural Health
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Medical Disclaimer
This web site is not designed to, and does not, provide medical advice. all content (“content”), including text, graphics, images and information available on or through this web site are for general informational purposes only.
The content is not intended to be a substitute for professional medical advice, diagnosis or treatment. never disregard professional medical advice, or delay in seeking it, because of something you have read on this web site. never rely on the information on this web site in place of seeking professional medical advice.
The owner of this website is not responsible or liable for any advice, course of treatment, diagnosis or any other information, services or products that you obtain through this site. You are encouraged to confer with your doctor with regard to information contained on or through this web site. After reading articles or other content from this web site, you are encouraged to review the information carefully with your professional healthcare provider.
DISCLAIMER FOR SERVICES PROVIDED
The intent of any nutritional recommendation is to support eh physiological and biochemical processes of the human body, and not to diagnose, treat, cure, prevent any disease or condition. Always work with a qualified medical professional before making changes to your diet, prescription medication, lifestyle or exercise activities.
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6240 Bankers Road, Racine, WI 53403
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