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Screening Survey – Abundant Life Chiropractic Harrisonville

by | May 19, 2022

Displaying 1 - 24 of 24

Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:Recently Experienced Symptoms:
11/06/2022Daniel CampbellEmail hidden; Javascript is required.(816) 582-096411/10/202210:40 AM

Dr. Rebekah

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Disc Problems
  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Disc Problems
11/06/2022Lindsey CarterEmail hidden; Javascript is required.(816) 719-966111/10/202208:00 AM

Dr. Rebekah

  • Back Pain
  • Hip/Leg Pain
  • Headaches/Migraines
  • Back Pain
  • Hip/Leg Pain
  • Headaches/Migraines
11/06/2022Robbie ReynoldsEmail hidden; Javascript is required.(816) 591-846311/14/202202:50 PM

Dr. Rebekah

  • Back Pain
  • Sinus/Allergies
  • Hip/Leg Pain
  • Headaches/Migraines
  • Back Pain
  • Sinus/Allergies
  • Hip/Leg Pain
  • Headaches/Migraines
10/01/2022John JohnsonEmail hidden; Javascript is required.(660) 351-583411/08/202204:30 AM

Dr. Rebekah

  • Back Pain
  • Neck Pain
  • Headaches/Migraines
  • Back Pain
  • Neck Pain
  • Headaches/Migraines
10/21/2022Test Test 10/25Email hidden; Javascript is required.(913) 634-865610/25/202208:00 AM

Test Hville Health Fair

  • Back Pain
  • Back Pain
10/21/2022Kathy BrownEmail hidden; Javascript is required.(816) 806-048811/01/202209:00 AM

Dr. Rebekah

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Disc Problems
  • Sciatica
  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Disc Problems
  • Sciatica
10/20/2022Sarah UnderwoodEmail hidden; Javascript is required.(816) 666-317110/26/202211:15 AM

Dr. Rebekah

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Ear Aches
  • Hip/Leg Pain
  • Headaches/Migraines
  • Disc Problems
  • Numbness/Tingling
  • Sciatica
  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Ear Aches
  • Hip/Leg Pain
  • Headaches/Migraines
  • Disc Problems
  • Numbness/Tingling
  • Sciatica
09/29/2022Christina FergusonEmail hidden; Javascript is required.(816) 378-144010/05/202211:15 AM

Dr. Rebekah Paid $20

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Numbness/Tingling
  • Shoulder/Arm Pain
  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Numbness/Tingling
  • Shoulder/Arm Pain
09/29/2022Test 2 Test 2Email hidden; Javascript is required.(913) 634-865609/29/202211:20 AM

Dr. Rebecca

  • Back Pain
  • Back Pain
09/27/2022Test TestEmail hidden; Javascript is required.(816) 699-558210/12/202210:30 AM

Test

  • Back Pain
  • Back Pain
09/24/2022Daniel PineEmail hidden; Javascript is required.(816) 506-139109/29/202202:00 PM

Dr. Rebekah -Harrisonville

  • Back Pain
  • Back Pain
09/17/2022Megan VogtEmail hidden; Javascript is required.(618) 973-506309/21/202212:15 PM

Dr. Rebecca

  • Back Pain
  • Hip/Leg Pain
  • Headaches/Migraines
  • Back Pain
  • Hip/Leg Pain
  • Headaches/Migraines
09/16/2022Garland Janse ClaboughEmail hidden; Javascript is required.(660) 679-210010/03/202203:30 PM

Dr. Rebecca

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
09/15/2022Shana CoppedgeEmail hidden; Javascript is required.(816) 853-726409/20/202210:15 AM
  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
  • Shoulder/Arm Pain
  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
  • Shoulder/Arm Pain
08/18/2022Lisa EhrhardtEmail hidden; Javascript is required.(417) 540-100509/08/202204:45 PM

Dr. Rebecca

  • Back Pain
  • Back Pain
08/18/2022Stacey SandersEmail hidden; Javascript is required.(816) 200-382708/23/202208:10 AM

Dr. Rebecca

  • Neck Pain
  • Neck Pain
08/17/2022Brandon HordEmail hidden; Javascript is required.(816) 582-314509/06/202204:45 PM

Dr. Rebekah

  • Back Pain
  • Neck Pain
  • Back Pain
  • Neck Pain
08/17/2022Becky CampbellEmail hidden; Javascript is required.(816) 582-388708/29/202204:40 PM
  • Back Pain
  • Neck Pain
  • Numbness/Tingling
  • Back Pain
  • Neck Pain
  • Numbness/Tingling
08/09/2022Maustin OtterstatterEmail hidden; Javascript is required.(920) 904-654208/09/202201:10 PM
  • Back Pain
  • Hip/Leg Pain
  • Back Pain
  • Hip/Leg Pain
08/06/2022Ellie Mae AndersonEmail hidden; Javascript is required.(816) 258-052908/10/202203:30 PM
  • Ear Aches
  • Ear Aches
07/30/2022Jeremiah NiebuhrEmail hidden; Javascript is required.(513) 535-709208/08/202202:30 PM
  • Back Pain
  • Sciatica
  • Shoulder/Arm Pain
  • Back Pain
  • Sciatica
  • Shoulder/Arm Pain
07/30/2022Bobbi KeimEmail hidden; Javascript is required.(816) 605-098308/03/202203:30 PM

Scoliosis’

  • Back Pain
  • Neck Pain
  • Sciatica
  • Back Pain
  • Neck Pain
  • Sciatica
07/29/2022Sean HornbeckEmail hidden; Javascript is required.(816) 721-693108/01/202204:15 PM
  • Back Pain
  • Back Pain
07/29/2022Sean HornbeckEmail hidden; Javascript is required.(816) 721-693108/01/202204:15 PM
  • Back Pain
  • Back Pain
Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:Recently Experienced Symptoms:

Displaying 1 - 24 of 24