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Screening Survey – Riggs Chiropractic – Riverton

by | May 20, 2022

Displaying 51 - 56 of 56

Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:
08/02/2022Terry Shuey[email protected](417) 529-915908/10/202209:00 AM

Headaches, right shoulder

  • Headaches/Migraines
  • Shoulder/Arm Pain
07/29/2022Michayla Lawson[email protected](417) 540-686808/10/202210:00 AM

Hurts to breathe, mid back, both hips, headaches & migraines, left shoulder, torn labrum

  • Back Pain
  • Hip/Leg Pain
  • Headaches/Migraines
07/29/2022Austin Pease[email protected](918) 961-017808/03/202204:00 PM

Lbp, excessive sinuses

  • Back Pain
  • Sinus/Allergies
07/28/2022Nathan Long[email protected](620) 762-074007/28/202210:45 AM

Deg disc disease, lbp- sciatica- off to the right side, laminectemy

  • Back Pain
  • Sinus/Allergies
  • Sciatica
07/27/2022Tuesday Williams[email protected](417) 242-945508/09/202211:00 AM

Lbp, sharp pain in the middle, tailbone & hips - right one is so bad it becomes numb, left side neck pain, constant ear pain, injury long time ago in hips especially right, headaches-constant, lb & bottom numbness, shoulder arm pain-constant, does have fibromyalgia

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Ear Aches
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
  • Sciatica
  • Shoulder/Arm Pain
07/26/2022Becca DoByns[email protected](620) 249-901207/26/202202:30 PM
  • Back Pain
Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:

Displaying 51 - 56 of 56