Welcome to Lobacz Chiropractic
When a person seeks the services of a chiropractor, it is essential that they fully understand the objectives of that particular chiropractor.
We have one goal at Lobacz Chiropractic that is to restore and maintain the integrity of the spinal cord and its nerve roots. These vital nerve pathways are located in and protected by the bones of the spine. Misalignments of the vertebrae (bones of the spine), which interfere with the function of these nerve pathways, are called vertebral subluxations. Subluxations are caused by many of the things you do everyday and keep your whole body from functioning properly. It is our absolute conviction that the body is always better off without this interference.
Consequently, the objective of Lobacz Chiropractic is to provide a chiropractic adjustment to correct subluxation thereby restoring normal nerve function. It is not the objective or intention of Lobacz Chiropractic to fix, treat or attempt to cure any physical, mental or emotional ailments or to give advice about any ailments. With a proper nerve supply your whole body is better able to reach its full potential and to express more life.
The information we receive from you is important. We ask only that which is necessary for your care here at Lobacz Chiropractic. Please fill out the forms completely and to the best of your ability. If you have any questions or if there is any information you feel we should know, please mention it to the chiropractor. Be aware, we do not furnish notes to insurance adjusters, disability handlers or insurance companies. If you wish to try and receive reimbursement on your own for your care, that is fine, but we will not aid in the process by submitting any forms or documentation on your behalf, or to you. Also, any pictures taken when filling out this form is only for internal use, so we have a picture of you on file in our system. When signing this agreement, our system will take a snapshot of the person signing the form.
I have read the above, understand it fully, and choose to receive chiropractic for ourselves and our family members (listed below) on this basis.