INFORMED CONSENT FOR CHIROPRACTIC CARE
To the patient (or their parent, legal guardian, court appointed conservator, or agent): Please read this entire form prior to signing it. It is important that you understand the information contained in this form. Please ask any questions prior to signing this form if you are unclear about anything in this form.
Chiropractic Adjustments –
The primary treatment render by the Doctor of Chiropractic to you will be chiropractic
adjustments, which are purposely intentioned movements of bones with the desired effect being to remove interference to nerves, which then allows your body to use its innate ability to heal itself.
Chiropractic adjustments also have the desirable effect enabling muscles, tendons, and ligaments to properly function and heal, and also allows blood flow to properly occur.
Chiropractic adjustments can be made by either the use of hands or mechanical instruments to any bone or joint in the body including both spinal and extremity bones. You may or may not hear an audible sound, which is just air being released from the joint space as bones are moved into their proper positions.
Other Procedures –
A physical examination may be performed in consideration with comorbidities to obtain a baseline level of functioning as well to partially determine an appropriate course of treatment and associated recommendations. The physical examination may include posture checks, range of motion testing, muscle strength testing, various neurological and orthopedic testing, vitals, and other testing. Radiology is the use of x-rays on the human body and is used to gain an inside perspective of the human body that cannot be obtained from a physical examination.
Treatment may include chiropractic adjustments, physical therapy (such as ultrasound, interferential therapy, massage therapy, exercise recommendations, etc.). Co-management with other physicians may be necessary in order to provide the proper care when managing ailments that can lead to potential risk of further damage to the body if the doctor has not been informed.
Material risks Inherent with Chiropractic Adjustments and Other Treatment –
As with any healthcare procedure, there are certain complications which may arise when
chiropractic adjustments and other care/procedures are performed. These complications include but are not limited to fractures of bones, disc injuries, dislocations, muscle strains, cervical myelopathy, strokes, radiation exposure, costovertebral strains and separations, and burns.
Proper examination prior to any adjustment is necessary in order to reduce the risk of such complications. For example, informing your Chiropractor of osteoporosis will lead to a reduced risk of fractures during an adjustment. Informing your Chiropractor of a connective tissue disease will lead to a reduced risk of a dislocation following an adjustment.
Some patients may feel some stiffness and/or soreness following the first few days of treatment. Inflammation of tissues being manipulated can occur as it is a necessary process with realigning the body. For example, scar tissue is the development from where inflammation once was from a misalignment. Breaking down scar tissue helps to realign the body and produce greater range of motion, although it can re-inflame the tissue to a certain degree. Please let your Chiropractor know if any uncomfortable pain does occur. The Doctor of Chiropractic will make every reasonable effort for comfortability during the examination.
Potential Benefits of Chiropractic and Associated Care –
The vast majority of chiropractic patients tend to achieve good to excellent improvement in their physical conditions with chiropractic care. Improvement can be measured in many different ways, including reduction in pain, increased range of motion, less stiffness, increased athletic performance, and other ways. It must be remembered that different people get different results, different people have different pre-existing conditions, and are of different ages and occupations (with different types of physical stress).
Not obtaining chiropractic care following trauma such as whiplash or other effects of automobile accidents will cause injured muscles, tendons, and ligaments to heal improperly and be significantly weaker and more prone to reinjury as compared to receiving proper chiropractic care.
Alternatives to Chiropractic Care –
Other tools and devices may be used for the performance of a low force adjustment if the patient is not comfortable with high velocity adjustments. Please inform the Chiropractor if you do not feel comfortable with high velocity adjustments. The practitioner will make the necessary means using tools and/or devices that can bring about the same effect with realigning the body, allowing nerves and blood vessels to flow properly in order for the body to be able to communicate and bring nutrients to the rest of the organ systems.
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