DEHEN CHIROPRACTIC SCHUGEL FAMILY CHIROPRACTIC
  Home
  Dr. Monica Schugel
  Staff
  Contact Us
  Appointments
  Intake Forms
  Privacy Notice
  Map
  First Visit
  X-rays
  Chiropractic FAQ
  Wellness vs Ilness Care
  Conditions Treated
  First Aid Tips
  Anatomy Diagrams
  Newsletter
  Healthy Living Tips
  Patient Links
  Nutrition Links
  Chiropractic Links
  Research Links
  Political Links
  Articles Published


1706 Lor Ray Drive
North Mankato, MN 56003
Phone: (507) 388-7744
Fax: (507) 388-8001
Email:dehenchiro@juno.com


Intake Forms

New Patients,

Please feel free to visit the link below & print the intake forms. Please complete each of them & bring them along to your initial appointment. This will expedite the initial examination process for you.

 
Intake Forms
 
If your primary complaint is Low Back Pain, please also complete the following questionnaire. Revised Oswestry Low Back Questionnaire
 
If your primary complaint is Neck Pain, please also complete the following questionnaire. Vernon-Mior Neck Index
 
If your primary complaint is Headache, please also complete the following questionnaire. Headache Index
 
If your primary complaint is Shoulder or Arm Pain, please also complete the following questionnaire. DASH
 
If your primary complaint is Leg Pain, please also complete the following questionnaire. Lower Extremity
 

Thanks for your help!

Back to Wellness Clinic Staff