Please take your time to carefully fill out the medical history form. It is a very important basis for your first treatment in our practice. If you do not wish to provide certain personal information in writing, you are free to do so. Your information will of course be treated confidentially and is subject to medical confidentiality.
Thank you very much, IHR-CHIROPRAKTOR Team
(Fields marked with * are required)
Your current complaints
Your health background
Your daily habits
Knowledge and conscience Headline *