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Screening Survey – Riggs Chiropractic – Riverton

by | May 20, 2022

Displaying 1 - 25 of 56

Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:
12/10/2022Shauna Qualls[email protected](620) 762-124612/12/202208:00 AM

Rayleigh Qualls. 6 years old. Scanned earlier in year and more neck. Needs Monday and late as possible in the afternoon. Scheduling best on Mondays. NO APPT, NEED TO CALL

  • Neck Pain
12/10/2022Kevin Miller[email protected](620) 704-946612/12/202208:00 AM

Columbus holiday fair. Works for railroad. Scheduling is hard due to changing. Been to a chiropractor before but has been awhile. NO APPT AT THIS TIME

  • Back Pain
  • Neck Pain
12/10/2022Shirley Redd[email protected](620) 674-125812/12/202208:00 AM

Knees, neck and headache. Columbus holiday fair. Used to work at Ace Electric in Columbus. Been to a chiropractor before but it has been awhile. NO APPT AT THIS TIME.

  • Neck Pain
  • Headaches/Migraines
12/10/2022Kevin Miller[email protected](620) 704-946612/12/202208:00 AM

Columbus holiday fair. Works for railroad, scheduling hard. Been to a chiro but been awhile. Wife owns heavenly designs creations (booth next to ours). NO APPT AT THIS TIME

  • Back Pain
  • Neck Pain
12/10/2022Jase Rosales[email protected](620) 429-620912/12/202208:00 AM
  • Neck Pain
  • Headaches/Migraines
12/08/2022Dean Teel[email protected](620) 704-654412/14/202204:45 PM

Left shoulder RH LBP tingling in leg every now and then- Alexis

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Numbness/Tingling
  • Sciatica
  • Shoulder/Arm Pain
11/30/2022Jake Kanmore[email protected](620) 268-998312/08/202207:00 AM

Alexis- often sinus issues

  • Sinus/Allergies
11/29/2022Sydney Larson[email protected](417) 236-694612/07/202211:45 AM

Becca- Lbp,

  • Back Pain
11/29/2022Ryan Phillips[email protected](417) 456-812112/06/202207:30 AM

Becca- lbp, leftleg, headaches cpl/week,

  • Back Pain
  • Hip/Leg Pain
  • Headaches/Migraines
11/29/2022Monica Miller[email protected](620) 704-137912/07/202204:15 PM

Becca -mid lbp, hip pain, leg pain, shoulder, sits all desk all the time

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Shoulder/Arm Pain
11/22/2022Cheron Myers[email protected](417) 499-380011/30/202202:45 PM

Becca- JBirds, pd-clover, shoulder pain, ubp, ear aches, sciatica-right tingling, deg disc,

  • Back Pain
  • Ear Aches
  • Hip/Leg Pain
  • Numbness/Tingling
  • Sciatica
  • Shoulder/Arm Pain
11/22/2022Kelsey Lewis[email protected](417) 434-107912/01/202211:30 AM

Becca- 5star nutrition, Left shoulder,

  • Back Pain
  • Neck Pain
  • Headaches/Migraines
  • Shoulder/Arm Pain
11/15/2022Rayanna Lee[email protected](417) 317-355311/22/202207:00 AM

Becca- riv high school, neck, sciatica-radiates right, right shoulder arthritis

  • Neck Pain
  • Sciatica
11/15/2022Sarah Haskins[email protected](417) 629-229111/30/202204:00 PM

Becca- riv high- lbp, breast reduction, neck, migraines, chronic, sciatica-right,

  • Back Pain
  • Neck Pain
  • Headaches/Migraines
  • Sciatica
11/15/2022Tiffany Long[email protected](417) 952-074601/02/202202:45 PM

Becca- riv high- hips, sciatica-right side, X-ray(3 yrs ago) shows spine turned a bit

  • Back Pain
  • Ear Aches
  • Hip/Leg Pain
  • Sciatica
11/15/2022Jordan Morton[email protected](417) 291-941711/28/202204:15 PM

Becca- riv high- Back pain, mid & upper back, sciatica-left side, preg. 10 weeks

  • Back Pain
  • Headaches/Migraines
  • Sciatica
11/14/2022Will Mallatt[email protected](620) 474-518311/17/202209:00 AM

Becca- Riverton High School- Sciatica-right leg, occasionally neck pain,

  • Neck Pain
  • Hip/Leg Pain
  • Sciatica
11/11/2022Abbie Knox[email protected](417) 569-751611/21/202212:15 PM

Hip-right, headaches 2/wk, legs fall asleep fast,

  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
11/10/2022Mary Mitchell[email protected](620) 719-621012/07/202202:00 PM

Ubp, sciatica left side into foot, shoulder,

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Headaches/Migraines
  • Sciatica
11/09/2022Morgan Queripel[email protected](417) 771-704911/15/202202:45 PM

Becca-JBirds- lbp & sides, earaches, constant hip or leg pain, chronic migraines, n& t in feet,

  • Back Pain
  • Ear Aches
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
11/09/2022Kristi Williams[email protected](417) 850-076211/21/202202:45 PM

Becca- JBirds- PD- Clover, Lbp, headaches/2wk, n & t in feet, sciatica-radiates-left

  • Back Pain
  • Headaches/Migraines
  • Numbness/Tingling
  • Sciatica
11/08/2022Larry Wilson[email protected](918) 919-252711/16/202209:00 AM

Becca- Weston’s, Neck pain, stress knots, scoliosis, shoulders,

  • Neck Pain
  • Numbness/Tingling
11/08/2022Tracee Kerr[email protected](918) 325-042911/16/202209:00 AM

Becca- Weston’s, Everywhere bp, ring, both hip legs, migraines a couple a month, cpl headaches, feet, radiates on right side, right shoulder

  • Back Pain
  • Neck Pain
  • Ear Aches
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
  • Sciatica
  • Shoulder/Arm Pain
11/02/2022Louis Vargas[email protected](417) 312-768111/03/202209:15 AM

Lbp, sciatica- right leg tingling & pain all the way down, neck pain,

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Numbness/Tingling
  • Sciatica
10/13/2022Ray Kelly[email protected](918) 608-945910/19/202209:45 AM

Becca-Quapaw fitness, mid-lbp,

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

Displaying 1 - 25 of 56