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Screening Survey – Atchley Chiropractic Centers – Prosper

by | Aug 4, 2022

Displaying 76 - 81 of 81

Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:
08/10/2022Jalyn ColeEmail hidden; Javascript is required.(405) 200-823908/16/202205:00 PM

10/24/01
Paid $49 cash
Female

  • Back Pain
08/10/2022Jordan OwensEmail hidden; Javascript is required.(214) 724-272508/10/202201:57 PM
  • Back Pain
08/10/2022Berni CarterEmail hidden; Javascript is required.(817) 845-527408/17/202203:00 PM

Swollen right hand with numbness
11/20/79

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Ear Aches
  • Headaches/Migraines
  • Numbness/Tingling
  • Sciatica
  • Shoulder/Arm Pain
08/10/2022Abbie WallaceEmail hidden; Javascript is required.(425) 985-288908/26/202210:00 AM

3/31/82
Shakertins moms day out
Paid $20

  • Hip/Leg Pain
08/08/2022Sharon AuthersEmail hidden; Javascript is required.(225) 978-476708/16/202203:00 AM

Maniers- vertigo and tendinitis
Inner ear

  • Back Pain
  • Disc Problems
08/06/2022Jeff SpannEmail hidden; Javascript is required.(469) 668-710408/11/202204:30 PM

Some back spasm pain
03/24/73

  • Back Pain
Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:

Displaying 76 - 81 of 81