Set C – For Pain Anywhere else in the body besides, the...

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Set C – For Pain Anywhere else in the body besides, the neck, shoulder, upper back, mid-back and lower back. i.e. pain in the legs or arms. ~***~Please Remember…~***~ If you need to fill out the Update papers, only fill out pages 2, 3, 5, and 6. Page numbers are located at the bottom of the pages on the left side. If you need to fill out the Progress Report papers, only fill out pages 4, 5, and 6. Again to help you better decide whether you need the Update Form or the Progress Report: Update Form is for patients who have stopped care, are wishing to resume care and have not seen the doctor within a three year period. The Progress Report is for patients who are having a re-examination done, per the doctor’s request. Once again, if it has been over three years since you have seen the doctor, since the time away from care so been so great; please fill out the New Patient Forms. Do not hesitate to call our office at (908) 852 – 6752 if you have any questions.

Transcript of Set C – For Pain Anywhere else in the body besides, the...

Page 1: Set C – For Pain Anywhere else in the body besides, the ...drdale.chirodirectory.com/images/doctor/024460/c.pdf · Set C – For Pain Anywhere else in the body besides, the neck,

Set C – For Pain Anywhere else in the body besides, the neck, shoulder, upper back, mid-back and lower back. i.e. pain in the legs or arms.

~***~Please Remember…~***~

If you need to fill out the Update papers, only fill out pages 2, 3, 5, and 6. Page numbers are located at the bottom of the pages on the left side. If you need to fill out the Progress Report papers, only fill out pages 4, 5, and 6. Again to help you better decide whether you need the Update Form or the Progress Report:

Update Form is for patients who have stopped care, are wishing to resume care and have not seen the doctor within a three year period. The Progress Report is for patients who are having a re-examination done, per the doctor’s request. Once again, if it has been over three years since you have seen the doctor, since the time away from care so been so great; please fill out the New Patient Forms. Do not hesitate to call our office at (908) 852 – 6752 if you have any questions.

Page 2: Set C – For Pain Anywhere else in the body besides, the ...drdale.chirodirectory.com/images/doctor/024460/c.pdf · Set C – For Pain Anywhere else in the body besides, the neck,
Page 3: Set C – For Pain Anywhere else in the body besides, the ...drdale.chirodirectory.com/images/doctor/024460/c.pdf · Set C – For Pain Anywhere else in the body besides, the neck,
Page 4: Set C – For Pain Anywhere else in the body besides, the ...drdale.chirodirectory.com/images/doctor/024460/c.pdf · Set C – For Pain Anywhere else in the body besides, the neck,
Page 5: Set C – For Pain Anywhere else in the body besides, the ...drdale.chirodirectory.com/images/doctor/024460/c.pdf · Set C – For Pain Anywhere else in the body besides, the neck,
Page 6: Set C – For Pain Anywhere else in the body besides, the ...drdale.chirodirectory.com/images/doctor/024460/c.pdf · Set C – For Pain Anywhere else in the body besides, the neck,