Drummond Chiropractic, LLC

Bloomington
Ellettsville

812-336-2423
812-876-5095

4712 East State Road 46
202 East Temperance St

	Subjective Complaint Form New Patient Form
	Past Health History and Review of Systems Form New Patient Form
	Financial Responsibilitiy and Insurance Information Form New Patient Form
	Consent to Treat a Minor This New Patient Form only needs to be completed if the New Patient is a Minor. It must be signed by a legal guardian of the minor.
	Advice for a Healthy Back These are simple rules to follow to help keep the back healthy. Note: This is general advice, and may not be for your specific needs and/or limitations.
	Fall Prevention This document was designed to help those preparing a space for patients that have become vulnerable to falls. Factors that increase vulnerability to falls are brittle bones (osteoporosis), being over age 80, changes in balance and walking patterns, changes in vision and sensation, and taking multiple medications.