New Patient Forms
Below are links to our new patient forms. All new patients are required to fill out these forms on their first visit to Collyard Chiropractic. They provide us with a documented background of your personal information, any ongoing health issues and the primary reasons for your initial visit. They also help us recommend the best possible treatment for you.
We know you’re busy and your time is precious. By filling out these forms prior to your first visit, we can help save you that precious bit of time in our office and get right to business on your first visit. Simply click on the following links, print the forms, fill them out and bring them with you on your first visit. We look forward to seeing you then!
Patient Intake Form
Health Questionaire
Medical History Form
Family History Form
Please note: These forms are in PDF format. You can probably view and print them right from your browser, but if that doesn’t work, you may need to install Adobe Reader or some other PDF reading software. You can download Adobe Reader for free from Adobe’s website.
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Testimonials
Twice I requested treatment, one for my neck and the other for a muscle in my right hip. The next problem caused me very limited head movement to either side. After several weeks of adjustments and doing the exercises Dr. Carrie had given me to do along with the treatments, the condition was totally resolved with no use of any drugs.
The right hip problem had gotten to the point that using steps or putting on shoes was next to impossible. I had to get creative with putting on shoes. Again, after several weeks of chiropractic adjustments and exercises, the pain was gone and has not returned. No drugs were used this time either.
I sought chiropractic treatment because if I went to a regular physician, I would be given muscle relaxers which would “mask” the real problem. I wanted to be healed of the pain and limitations in a safe way. Dr. Carrie helped make my recovery happen!
In June of 2003, I was diagnosed with stage 4 colon cancer. Dr. Carrie discussed with me the benefits of EDS even though I had been given the cancer diagnosis. I began doing the recommended treatment of detoxifying and supplements for areas of the body that were affected a month before I went for surgery. I went into surgery feeling better and stronger. I stopped the detox while on chemotherapy, but continued on the supplements.
I am pleased to tell you that I am now at 21 months with no signs of cancer, even though I was told that I had less than a 10% chance of survival. Thank you Dr. Carrie!
I had been suffering from a very painful choking feeling in my throat and chest for about 6 months. I felt weak and tired because I was really unable to eat due to the pain. I’d been to many medical doctors and tried a variety of medicines that they prescribed all to no avail.
After several chiropractic adjustments with Dr. Carrie, I feel 95% better! The adjustments helped clear my throat and eating is no longer uncomfortable or painful. I now feel stronger and I have more energy and ambition than I have in months. I would definitely recommend Dr. Carrie and her staff!
My name is Pam Kaiser and I’m a nurse who works full time on the night shift as a supervisor at a large psychiatric hospital. Needless to say, I’m on my feet a lot, and at the end of my shift my right hip was so sore I could barely walk. Four years ago, while teaching my son to skate at a roller rink, I was plowed into from behind by a teen aged speed demon. I fell on my back and my left leg was thrown above my head and bounced off the floor. My left leg was stretched – tearing blood vessels and muscles – I was on crutches for a month. A trip to the ER ruled out dislocation or breaks in my bones. I was told that in time the muscles and blood vessels would heal.
Well, three years later my right hip is STILL killing me at the end of my shift. Multiple visits to Medical Doctors and orthopedic specialists along with CAT scans and MRI’s left me frustrated and defeated. I had always been very active, but not any more.
I had never been to a chiropractor simply because it had never occurred to me. On my first visit, Dr. Carrie told me that my left leg had remained somewhat stretched and my right leg was more than an inch shorter than my left leg – which explained why I had so much pain in my right hip.
After a few adjustments, I was pain free for the first time in four years. Now, with intermittent adjustments, I am able to do all the things I used to do!
Thank you, thank you, thank you Carrie! You worked a miracle in my life!
I came to see Dr. Carrie for severe low back pain. The back pain was bad enough, but I was also getting pain and numbness in both of my legs. I could barely move; walking, sitting and standing all hurt! I was forced to take time off from work. After about a week of suffering, I finally went to see Dr. Carrie. Following only a few treatments, I got much needed relief from my back and leg pain. It wasn’t long before I was able to return to normal activity.
At first I didn’t believe in chiropractic. But after going, I wish I had done it sooner. I now recommend Dr. Carrie to anyone who is suffering. My family and I are patients for life!
I’ve been suffering with neck, shoulder and low back pain and headaches for several years due to fibromyalgia. The pain prevents me from working and has cut my daily activities and hobbies to a minimum. I’ve tried many things in search of pain relief including physical therapy, pain clinics, and medication. Chiropractic care and acupuncture have given me the best results. After my treatments I feel refreshed, less stressed, my alertness is better, muscles are more relaxed, I have less pain. I would not be without Dr. Carrie and chiropractic! They are at the top of my list for health maintenance!
I’ve struggled with fibromyalgia for 10 years. Over the last few years it has gotten progressively worse, causing severe fatigue, aches, pains and limiting my ability to perform everyday tasks at home and work. I’ve tried many treatments from meds, physical therapy, massage and chiropractic care and none of these provided long term relief.
I heard about Dr. Carrie’s expertise with acupuncture and desperately wanted to try it. I was impressed by the immediate relief the first treatment provided. I then decided to add deep tissue massage and Dr. Carrie’s detox program. The long term results have been incredible!
Today I have so much energy, I feel like a new person. My family and I thank you, Dr. Carrie, for the wonderful care and the relief you’ve provided me.
I had visited Dr. Carrie’s website and was very impressed by her testimonials and also her vision for wellness. Later, she was recommended by a client who had a similar medical situation as mine. I decided to go ahead and see if this was the real deal. I have had chiropractic and acupuncture care in the past but did not get the feeling of genuine caring or commitment to my wellness as I did at Collyard Chiropractic.
Everything in life depends on something else to work properly (or better), so I believe in combining all of Collyard Chiropractic’s services for an overall well state of mind and body.
I have and continue to urge family, friends, and even medical professionals who have struggled with medical issues. Dr. Carrie will put every effort into the best treatment for each situation without judgment. She will provide you excellent customer service no matter if you are a patient who only comes in when it REALLY hurts, or on a regular maintenance schedule. Dr. Carrie and her team “Get It!”
Just wanted to give a word of thanks for all you have taught us. Charlie came down with a 101 temp on Saturday. It continued through Sunday while reaching over 102. We started on the Colostrum mixed in his milk and tea tree oil at every opportunity we had. Sunday he woke up with a fever (?) of 99. He took a long nap and woke up energized, ready to eat & take on the world!
We never would have had this knowledge without you!
The fussiest baby on the block was so relaxed and calm after our appt… so thankful!
