Symptoms:

Headache/Tension

Digestive Disturbance

Low Back Pain

Elbow Pain

Nervousness

Ringing in Ears

Allergies

Knee Pain

Neck Pain

Fatigue/Tired

Difficulty Sleeping

Pain Anywhere in Body

Shoulder Pain

Ankle/Foot Pain

Numbing/Tingling in Arms or Hands

Tension Across Top of Shoulders

Pain Between Shoulder Blades

Numbing/Tingling in Legs or Feet

Wrist/Hand Pain

Irritability

Weight Trouble

Hip Pain

Dizziness

Effects: Which Of The Following Do You Experience As A Result Of Your Symptoms?

Moody

Irritable

Interrupt Sleep

Restricted on Daily Activities

Do The Symptoms Above Affect Your Work Performance? If So, Which Of The Following Are Affected?

Decision Making

Poor Attitude

Decreased Productivity

Exhausted at End of Day

Unable to Work Long Hours

Which Of The Following Can Be Attributed To Your Symptoms?

Lose Patience With Spouse or Children

Hinders Ability to Exercise or Participate in Sports

Restricted Household Duties

Interferes with Ability to Participate in Hobbies or Other Desired Activities

Results: If You Checked Any Of The Above Items, Then You Could Be Suffering From Excessive Stress, Structural Misalignment Or Pinched Nerves. We Can Help You Because We Gently Treat Your Body, Naturally, Without Drugs To Remove The Stress And Imbalances That Cause Health Problems. If You Would Like To Discuss Your Symptoms And Get Information On Treatment Options Then Please Contact Us Or Let Us Know The Best Time To Contact You.* Please Contact Me Via

Phone

Please do not submit any Protected Health Information (PHI).