There are many common symptoms that signal the need for chiropractic or massage therapy. Select a symptom for more information:

CHIROPRACTIC
     Headaches & Migraines
     Hip, Leg, Knee, Foot & Sciatica
     Lower Back Pain
     Stress, Fatigue, Cold & Flus
     Upper Back/Neck/Shoulder/Arm Pain
     Whiplash
     Numbness/Tingling/Pinched Nerves
     Pregnancy/Pre-Natal
     Animal Chiropractic

ORTHOTICS
     Plantar Fasciitis
     Knee Pain & Shin Splints
     Lower Back Pain
     Sports/Athletics
     Self Examination

MASSAGE THERAPY
     Fatigue
     Stress/Relaxation
     Flexibility/Mobility
     Shoulder Pain
     Athletic Injuries

We ask new patients to download, print, and complete the appropriate forms below and bring to your first appointment. All files are in PDF format.

Patient Health Questionnaire

Patient Information - ADULT

Patient Information - CHILD

Worker's Comp Questionnaire

Accidental Injury Form

What to Expect During Your First Visit

 What to Expect During Your First Visit


Welcome to our office! We appreciate the confidence you have placed in our doctor and staff. We believe that a clear definition of our office policies will allow you and your doctor to concentrate on the first priority – REGAINING AND MAINTAINING YOUR HEALTH. We hope to eliminate any apprehension regarding your first visit to our office by giving you some understanding of what to expect. Your health and welfare are our main concern; please allow our doctor and staff to assist you in any way that may be necessary during your course of treatment in our office as we consider ourselves your partners in good health.

You have been asked to complete several forms. These documents allow our doctor to assess and understand your past and current health situation. The New Patient Intake Form seems lengthy, but most of the questions require only “YES” or “NO” answers – the information you provide is crucial in determining the best course of care. Please ask our Front Desk for assistance if required. Once you’ve completed these forms, you will be escorted to the doctor’s office to begin your consultation. Following your consultation the doctor will perform a thorough chiropractic, orthopedic, physical and neurological exam. The purpose of this examination is to locate and establish the cause of your complaint so a treatment plan can be developed for your specific needs.

© 2013 Theresa L. Burns, D.C.   •   692 W. Schuylkill Road, Pottstown, PA 19465   •   Phone: (484) 624-3726   •   Fax: (484) 949-8495

Gentle Chiropractic

Headaches & Migraines
Hip, Leg, Knee, Foot & Sciatica
Lower Back Pain
Stress, Fatigue, Cold & Flus
Upper Back/Neck/Shoulder/Arm Pain
Whiplash
Numbness/Tingling/Pinched Nerves
Pregnancy/Pre-Natal
Decompression Therapy

Orthotics

Plantar Fasciitis
Knee Pain & Shin Splints
Lower Back Pain
Sports/Athletics
Self Examination
Massage Therapy

Fatigue
Stress/Relaxation
Flexibility/Mobility
Shoulder Pain
Athletic Injuries

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