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Confidential Patient Health Record for Chiropractic Treatment

Chiropractors, have each new patient fill out this 5-page Confidential Health Record and Information Sheet prior to receiving chiropractic treatment.

The form includes sections for personal and medical history, job-related injuries, current health condition, and a patient consent form for treatment.

This Confidential Health Record and Information Sheet for Chiropractic Treatment is provided in MS Word format and is fully editable. Pay for the form once, and it's yours to use as often as you require.

Download: Confidential Patient Health Record for Chiropractic Treatment

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