• Chiropractic focuses on the nervous system and spinal cord. During chiropractic treatment, the doctor will use his/her hands or a mechanical device in order to align your spine to correct interference to the nervous system and improve the body’s ability to control and coordinate many functions. You may feel a “click” or “pop”, such as the noise when a knuckle is “cracked”, and you may feel movement of the joint.

    Possible Risks: As with any health care procedure, complications are possible following a chiropractic manipulation. Complications could include fractures of bone, muscular strain, ligamentous sprain, dislocations of joint, or injury to arteries of the neck. A minority of patients may notice stiffness or soreness after the first few days of treatment.

    The risks of complications due to chiropractic treatment have been described as “rare”, about as often as complications are seen from the taking of a single aspirin tablet. The risk of stroke has been estimated at one in a million to one in twenty million, and can be even further reduced by screening procedures.

    I understand the hazards and potential dangers involved in treatment by means of chiropractic. I believe that this treatment is in my best interest and I understand that no guarantee of results has been made.

    I understand that it usually requires a series of chiropractic treatments to significantly change a condition and receive benefit.

    My signature indicates that I have read and fully understand the above information regarding the consent to this procedure. I have had the opportunity to ask questions about any matter which I did not understand, and I have received satisfactory explanations to my questions. My signature below authorizes this procedure.
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  • The patient (or patient’s representative) and I have discussed this procedure, the risks and alternatives to this procedure. To the best of my knowledge, the patient (or patient’s representative) understands this procedure and consents to it.
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