New Patient Information Form

Welcome to Queen Street, Parnell,Takapuna & Botany Chiropractors and Acupuncturists.
In order to provide you with professional and efficient chiropractic and acupuncture care, we require
some personal details. Please take a moment to read and complete this form.
Chiropractic is a process that involves the adjustment of your spine to improve spinal function and in turnreduce irritation to your nervous system.The nervous system impacts on every muscle, organ and tissue in your body and for this reason it is necessary to complete a full orthopaedic and neurological assessment.
Acupuncture is one of the main forms of treatment in traditional Chinese medicine. It involves the use of sharp, thin needles that are inserted in the body at very specific points. This process is used to adjust and alter the body's energy flow into healthier patterns, and is used to treat a wide variety of illnesses and health conditions. They also uses various form of electrical nerve stimulation to reduce pain and muscle spasm.
This process involves:
- An interview which will include your complete health history.
- An orthopaedic and neurological examination.
- Spinal x-rays – if deemed necessary.
Your next visit will involve a report of findings where the results of your examination will be discussed and a care plan will be suggested by either the Chiropractor, Acupuncturist or both.
Thank you for completing this form.