Important Things to Consider on Completing an Intake Form at our office

intake formFor your initial appointment at our office, we will ask you to complete an intake form. Similar to information gathering paperwork at other healthcare institutions, these forms can be completed online at home before your appointment or in office. There are questions related to where you experience pain and the type of pain you experience. These types of questions relate to back pain, neck pain, headaches, pain in the shoulders, hips, feet, and other areas. We ask about your health history- surgeries, accidents, and other significant medical issues. Additionally, there are questions related to medications that you take- be sure to include all drugs, even nutrient supplements you use. We ask for this information to fully understand your health concerns and arrive at a complete diagnosis to treat you properly.

Sometimes patients leave out specific medical concerns because they think that they aren’t relevant to a chiropractic or acupuncture office. That couldn’t be further from the truth! It is essential that you tell us about other medical diagnoses or health concerns that you have in addition to musculoskeletal pain. For instance, we need to know about issues with digestion as this impacts your ability to assimilate nutrients and heal properly. The state of your heart and cardiovascular system affects blood flow and can affect pain and healing; your lungs and ability to breathe impacts energy and detoxification. Stress and mental issues affect sleep and wakefulness and healing on many levels- tell us about problems in these critical areas. Every organ in the body is crucial to wellbeing- please use the intake form to inform Dr.Okardmay about any health issues you have at this time and any relevant health concerns you have had in the past. Problems with digestion, respiration, cardiovascular system, stress, ears, eyes, nose, and throat as well as any other organ impairment are essential concerns to your chiropractor and acupuncturist. If you aren’t sure, ask. There is a section to describe familial health history- please fully express related health concerns there, as well.

Additionally, it is vital that we know about all your health concerns as they relate to the vertebral level of subluxation we seek to adjust. For instance, the lungs receive nerve innervation from the third and fourth thoracic vertebral levels, whereas the stomach is from the lowest thoracic region. It is crucial to care for each injured spinal unit and its destination pathway- please inform us of painful muscles, ligaments as well as organs and other tissues that need assistance. The chiropractic adjustment and acupuncture channel treatments strive to direct healing to all injured areas from the origin of illness.

We look forward to working with you and helping you heal on many levels. If a new health concern arises during the course of treatment, or if you remember something that you forgot to mention on your intake form, please refer it to Dr.Oskardmay during your regular treatment session. At Acupractic, we aim to help you heal on many levels.

Serving the communities of Chapel Hill, Carrboro, Durham, Hillsborough, and the rest of the NC Triangle

205 Providence Rd. Chapel Hill NC 27514 | Phone: (919) 929-1400

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