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Screening Survey – Riggs Chiropractic – Pittsburg

by | May 20, 2022

Displaying 26 - 46 of 46

Screening DateNameEmailPhoneAppointment DateAppointment TimeNOTES: (office use only)Recently Experienced Symptoms:
06/08/2023Megan HensleeEmail hidden; Javascript is required.(417) 813-662207/18/202210:30 AM

Screening @ __________; notes etc

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Headaches/Migraines
06/08/2023Mckenzy EdgeEmail hidden; Javascript is required.(620) 605-743806/13/202311:45 AM

Has 3 kiddos. C section w all 3 kids. Back pain when carrying kids. Has back spasms

  • Back Pain
06/08/2023Lily WebsterEmail hidden; Javascript is required.(620) 704-266506/23/200504:15 PM
  • Back Pain
  • Neck Pain
  • Headaches/Migraines
06/08/2023Riley HarrisEmail hidden; Javascript is required.(620) 687-201006/09/202308:45 AM
  • Back Pain
06/08/2023Ayla FordEmail hidden; Javascript is required.(620) 875-905406/09/202310:30 AM

Jimmy John’s. Low back and hips. Works 2 jobs Was a little for bbbs

  • Back Pain
  • Hip/Leg Pain
05/27/2023Maggie PostierEmail hidden; Javascript is required.(913) 309-182805/31/202310:15 AM

Screening at food trucks and fur babies. Hip pain. Sciatic and ankles. Nursing student at PSU. Knees hurt. Never seen a chiropractor

  • Back Pain
  • Ear Aches
  • Hip/Leg Pain
  • Sciatica
05/27/2023Toni WortonEmail hidden; Javascript is required.(620) 875-543206/02/202302:30 PM

Screening at Food Truck & Fur Babies. Neck pain from car accident 20 years ago. Hyper mobile and back always hurts

  • Back Pain
  • Neck Pain
  • Sinus/Allergies
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
12/14/2022Matt AbellaEmail hidden; Javascript is required.(620) 724-668301/01/202201:01 AM

Need to check on Medicare benefits following WC claim

7J20- V16 - FK48

May need to leave message

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Shoulder/Arm Pain
12/10/2022Megan VyhlidalEmail hidden; Javascript is required.(620) 875-334512/12/202208:00 AM

Test email

  • Back Pain
12/08/2022Leslie DicusEmail hidden; Javascript is required.(479) 567-271301/01/202301:01 AM

Screened at shorts

  • Neck Pain
11/29/2022Emily BiondoEmail hidden; Javascript is required.(913) 748-947512/13/202207:30 AM

Becca - Spring River - all over bp, prominent lwr right side pain, migraines(takes meds), carpel tunnel

  • Back Pain
  • Neck Pain
  • Headaches/Migraines
  • Numbness/Tingling
09/22/2022Ronald WuerdemanEmail hidden; Javascript is required.(620) 704-144709/27/202202:15 PM

Becca- BloodDrive, Mid back, hips, dull headaches since he had two strokes about a yr ago, numbness in fingers, shoulder pain - from baseball he believes yrs ago,

  • Back Pain
  • Neck Pain
  • Hip/Leg Pain
  • Headaches/Migraines
  • Numbness/Tingling
  • Shoulder/Arm Pain
09/21/2022Angela FalletiEmail hidden; Javascript is required.(620) 875-916609/29/202204:00 PM

Becca- Blood drive, Mid back, numbness in arms and fingers, neck pain,

  • Back Pain
  • Headaches/Migraines
  • Numbness/Tingling
  • Shoulder/Arm Pain
08/30/2022John TeeheeEmail hidden; Javascript is required.(620) 238-329509/06/202208:30 AM

Becca-Rhea Lana, PD- Clover, Lbp, fusion ruptured disc, hip pan,

  • Back Pain
  • Hip/Leg Pain
08/30/2022Ashley KmiecEmail hidden; Javascript is required.(443) 975-209409/01/202209:00 AM

Becca-Rhea Lana, mid-lbp, hip pain, pain while sleeping

  • Back Pain
  • Hip/Leg Pain
08/03/2022Jenny KennedyEmail hidden; Javascript is required.(620) 238-235208/08/202209:15 AM

Low back/ knees

  • Back Pain
08/03/2022Test TestEmail hidden; Javascript is required.(620) 249-584807/31/202208:00 AM

Notes test

  • Ear Aches
07/31/2022Hannah DanielsEmail hidden; Javascript is required.(620) 762-109608/01/202203:30 PM

CK Co Fair- Becca - All over bp, stiff neck, earaches once or twice a month, headaches every day, left shoulder pain

  • Back Pain
  • Neck Pain
  • Ear Aches
  • Hip/Leg Pain
  • Headaches/Migraines
  • Shoulder/Arm Pain
07/29/2022Deja ZwahlenEmail hidden; Javascript is required.(620) 249-094208/18/202209:00 AM

Mid back pain, ear aches- right, thumping noises in ears, left hip pain

  • Back Pain
  • Neck Pain
  • Ear Aches
  • Hip/Leg Pain
07/26/2022Test TestEmail hidden; Javascript is required.(620) 249-584807/26/202202:00 PM

Notes notes notes

  • Back Pain
  • Headaches/Migraines
  • Disc Problems
07/20/2022kayla riggsEmail hidden; Javascript is required.(712) 830-535708/01/202208:00 AM

this would be best patient ever

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

Displaying 26 - 46 of 46