Huntington Beach Upper Cervical ChiropracticHuntington Beach Upper Cervical Chiropractic
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Huntington Beach Upper Cervical Chiropractic — Case History

New Patient Health History Form

Personal Information

Previous chiropractic care?
Marital status
Pregnant?

About Your Health

The human body is designed to be healthy. Throughout life, events occur that can damage your health expression. This case history will uncover the layers of damage, especially to your nervous system, that resulted in poor health. Following your exam, your doctor will outline a course of care that will begin to correct the layers of damage and recover your innate health potential.

Present State of Health

Pains are:
Is this condition getting progressively worse?
Have you been under medical care?

Health History

Have you been in any accidents?
Have you had any surgeries?
Have you had any teeth problems?
Eye problems?
Hearing problems?
Exercise regularly?
Do or did you have any physical stress?
Do or did you have any mental stress?
Do or did you smoke?
Do or did you drink alcohol?
Other symptoms (check all that apply)

Person Responsible for Payment

Care Program

The purpose of upper cervical chiropractic care at this office is the detection, location, and correction of the vertebral subluxation that produces interference with the brain stem, spinal cord, and nerves. There are three phases of care. The relief phase corrects the most recent layer of spinal and neurological damage and usually reduces or eliminates symptoms. The correction phase corrects the years of damage that occurred while there were few symptoms. The wellness (strengthening) phase is long-term and most beneficial. These options will be explained at your report of findings. You'll then be able to begin a course of care that fits your health goals. No diagnosis, treatment, or curing of disease is offered at this office. I accept chiropractic care on this basis alone.

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Huntington Beach Upper Cervical Chiropractic

Specialist care for the cases other doctors couldn't solve.

Specialist in upper cervical chiropractic.

3D imaging for precise diagnosis.

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Contact Information

  • 16052 Beach Blvd. Ste. 130
    Huntington Beach, CA 92647
  • (888) 857-5510
  • Fax (714) 848-2968
  • info@hbucc.com

Office Hours

  • Monday & Thursday
    9:00 am - 1:00 pm, 3:00 pm - 6:00 pm
  • Tuesday
    9:00 am - 1:00 pm, 3:00 pm - 4:00 pm
  • Wednesday
    Closed
  • Friday
    9:00 am - 2:00 pm
  • Saturday
    9:00 am - 11:00 am
  • Sunday
    Closed
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