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1. What was your particular condition? When did it begin? How long have you had it? What
caused it? What did it feel like when it was at its worst?
TMJ, neck in the wrong position causing severe headaches
2. What have you tried in the past to get rid of your condition & what were the results? (Over the
counter or prescription medications, therapies, exercise, surgery, physicians, etc.)
Tylenol and advil
3. Describe how this condition/s might have affected you, your work, your family and social life,
and/or your hobbies/exercises.
Well, headaches might have made me a little grumpy. I know if I have a headache, I don't want to do as much.
4. Who referred you gr how did you fmd out about our office?
5. What results have you had? How has chiropractic changed or improved your life?
Well, less headaches which is just awesome.
6. Describe your impression of chiropractic, Dr. Alicia, and our team. Please include any
candid comments regarding Dr. Alicia, our team, your results, and what you would like to tell
It has really helped my neck, so I don't have as many or as bad headaches.
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