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Cultural Literacy. Louis MO: Saunders Elsevier, Best Practices in Clinical Chiropractic. Topics in Clinical Chiropractic Series. Gaitherburg MD: Aspen, Chiropractic Care of Special Populations.
Chiropractic Technologies. Sports Chiropractic. Osteoarthritis: Care and Management in Adults. Spinal Injury: Assessment and Initial Management. National Guideline Centre UK. Nordhoff LS. Identifying back pain subgroups: developing and applying approaches using individual patient data collected within clinical trials.
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Health Services and Delivery Research, No. Wainapel SF and Fast A, editors. Although there are different chiropractic varieties, some practitioners and therapy clinics prefer to create their own documents that can be easily associated with their websites, database systems, and documentation procedures. If your clinic aims to have their own chiropractic intake form, then you must follow the steps below to create a simple yet effective document that caters the necessary information of any patient:.
Add the name of the chiropractic clinic on the top of the form. This serves as an indication that the document is made and owned by your clinic. Indicate a patient information area. You may also see event planning intake forms. Lines that allow the patient to state the full legal names of his emergency contact representatives or authorized persons along with their phone numbers must be allotted in this area.
To make this section, checkboxes can be considered to provide options for the patient to indicate his medical state. In addition to this, a body diagram can also be attached as part of the form to allow the patient in marking areas where the pain is evident. Associated with the diagram are numbers that symbolize the level of pain that the patient feels identical to making a rating on a survey form. Enlist social activities with checkboxes.
In this section or area, the patient must be able to disclose what types of activities he is currently involved socially such as being part of groups or organizations and regularly taking alcohol or drugs.
The number of hours that the patient is able to sleep per night should also be catered in this section along with stress level that the patient is dealing with in his everyday living.
You may also see new patient intake forms. This must have areas where the patient will be able to provide a credit card authorization if he will be paying through his cards or bank account. Incorporate agreements and policy statements. Some of the agreements to be incorporated on the intake form includes a consent to treat statement, confidentiality agreement , medical information disclosure, and a policy agreement. The form also promotes a better way of communicating between the patient and the therapist which will then follow a more effective healing process and a stronger patient-therapist relationship.
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