Contents of the Template:
- Personal Information: A section dedicated to capturing the basic personal details of the patient, including contact information and emergency contact details.
- Insurance Information: Allows chiropractors to keep track of patients’ insurance details for billing and correspondence.
- Primary Care Physician Details: Vital for collaboration or referrals.
- Current Complaints: To understand the current ailments or discomfort the patient is facing, including a pain scale.
- Medical History: To gather past medical events that may influence current health or treatment plans.
- Family Medical History: Offers insights into potential hereditary health conditions.
- Medications: Ensures the chiropractor is aware of any medications the patient is currently taking, which might impact their treatment.
- Lifestyle Information: Helps in understanding a patient’s daily habits which can influence health.
- Consent Section: Ensures the patient understands and agrees to the proposed treatments.
Why Use This Template:
- Ease of Use: Formatted for straightforward data entry, ensuring all necessary information is collected.
- Streamlined Process: Organized systematically for a quick and efficient patient onboarding process.
- Compatibility: Available in multiple formats (Word and Google Docs), making it adaptable for various office setups.
- Professional: Presents a professional image, reassuring patients of the clinic’s dedication to their care.
- New Chiropractic Practices: Perfect for clinics that are just starting out and need a structured intake process.
- Expanding Clinics: For chiropractors integrating more services and wanting a uniform intake process.
- Interdisciplinary Clinics: Where chiropractic services are one of several offered, ensuring information consistency across disciplines.
- Digital Transitions: Clinics moving from paper-based to digital record-keeping, looking for adaptable digital formats.