• 1001-G East W.T. Harris Blvd Charlotte, NC 28213

    (704) 547-9494

    THE NATURE AND PURPOSE OF CHIROPRACTIC


    Adjustments are made by chiropractors in order to correct spinal extremity joint subluxations. One of the most common disturbances to the nervous system is the vertebral subluxation. This condition is one where one or more vertebra in the spine is misaligned sufficiently to cause interference and/or irritation to the nervous system. The primary goal in Chiropractic health care is the removal of nerve interference caused by subluxation.

    The chiropractic adjustment is the application of precise, high velocity movement of the spine over a very short distance. There are a number of different methods or techniques by which the chiropractic adjustment is delivered. Chiropractic adjustments are typically delivered by hand, but some may require the use of an instrument or other specialized equipment. In addition, physiotherapy or rehabilitative procedures may be included in the management protocol.

    I have been informed of the nature and purpose of chiropractic care, the possible consequences of care, and the risk of care, including the risk that the care may not accomplish the desired objective. Reasonable alternative treatments have been explained, including the risks, consequences and probably effectiveness of each. I have been advised of the possible consequences if no care is received. I acknowledge that no guarantees have been made to me concerning the result of the care and treatment.

    I HAVE READ THE ABOVE PARAGRAPH. I UNDERSTAND THE INFORMATION PROVIDED. ALL QUESTIONS I HAVE ABOUT THIS INFORMATION HAVE BEEN ANSWERED TO MY SATISFACTION

    HAVING THIS KNOWLEDGE, KNOWINGLY AUTHORIZE ACCIDENT RECOVERY CENTER TO PROCEED WITH CHIROPRACTIC CARE AND TREATMENT.


  • Parental Consent for Minor Patient