Select Page

Displaying 1 - 9 of 9

Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:
08/22/2022TEST Ricedr.rice@chiropro.com(618) 979-039808/28/202210:00 AM

This is a test 🙂

  • Back Pain
  • Hip/Leg Pain
04/18/2023Brailia Roulandbrailia@icloud.com(314) 250-575504/27/202305:30 PM

She did not pay, but really wants to come in!

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
04/18/2023Heather Halterhrniere@gmail.com(314) 210-592905/24/202305:00 PM

She bought a membership to the joint and that’s why she wants to come in May 24 earth at 5 PM!

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Hip/Leg Pain
  • Disc Problems
  • Numbness/Tingling
  • Sciatica
04/18/2023Brailia Roulandbrailia@icloud.com(314) 250-575504/27/202305:00 PM

She didn’t pay, but she really wants to come in!

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
04/18/2023Amy Wienstroeram.wienstroer@gmail.com(636) 390-901404/24/202308:30 AM

Wants to bring her family and ask her about her daughters and son!

  • Neck Pain
  • Headaches/Migraines
  • Numbness/Tingling
04/18/2023Ema McCartemagmoore15@gmail.com(314) 267-605704/28/202309:00 AM

She is looking for someone that does x-rays!

  • Back Pain
  • Numbness/Tingling
05/01/2023Phil Mcnairmcnairphilip@gmail.com(636) 779-300805/02/202310:30 AM

Said he has current numbness in his fingers on the ulnar side.

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Numbness/Tingling
  • Sciatica
  • Shoulder/Arm Pain
05/01/2023Doug Marquartdougiedoug1995@gmail.com(636) 221-970305/03/202303:30 PM

Assistant manager and was in a lot of pain. He was the reason we were able to do a L&L!

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Numbness/Tingling
  • Sciatica
  • Shoulder/Arm Pain
05/01/2023Bobby Youngrobertyoung380@gmal.com(636) 375-492905/02/202303:45 PM

Older guys that had some numbness in his toes.

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Numbness/Tingling
  • Sciatica
  • Shoulder/Arm Pain
Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms: