Terms of Acceptance & Consent To Treat
When a patient seeks chiropractic healthcare and we accept a patient for such care, it is essential for both to be working towards the same objective. It is important that each patient understands both the objective and the method that will be used to attain it. This will prevent any confusion or disappointment.
Adjustment: An adjustment is the specific application of forces to facilitate the body’s correction of segmental and somatic dysfunction of the spine and the extremities. Our chiropractic method of correction is by specific adjustments of the spine and/or the extremities.
Health: A state of optimal physical, mental, and social well-being, not merely the absence of disease or infirmity.
Chiropractic care, like all forms of healthcare, while offering considerable benefit may also provide some level of risk. This level of risk is most often very minimal, yet in rare cases, injury has been associated with chiropractic care. The types of complications that have been reported secondary to chiropractic care include sprain/strain injuries, irritation of a disc condition, and rarely, fractures. One of the rarest complications associated with chiropractic care, occurring at a rate between one instance per one million to one per two million cervical spine (neck) adjustments may be a vertebral artery injury that could lead to stroke. For comparison, the incidence of hospital admission attributed to aspirin use from major GI events of the entire (upper and lower) GI tract was 1219 events/ per one million persons/year and the risk of death has been estimated as 104 per one million users. The best available scientific evidence supports the understanding that chiropractic adjustment does not cause a dissection in a normal, healthy artery. Disease processes, genetic disorders, medications, and vessel abnormalities may cause an artery to be more susceptible to dissection. Strokes caused by arterial dissections have been associated with over 72 everyday activities such as sneezing, driving, visiting a hair salon, and playing tennis.
Prior to receiving chiropractic care from Compass Mobile Chiropractic, health history and physical examination will be completed. These procedures are performed to assess your specific condition, your overall health, and, in particular, your spinal health. These procedures will assist us in determining if chiropractic care is needed, or if any further examination or studies are needed. In addition, they will help us determine if there is any reason to modify your care or provide you with a referral to another health care provider. All relevant findings will be reported to you, along with any recommended future chiropractic, in a document known as your “care plan.”
It is important to note, we do not offer to diagnose or treat any disease. We only offer to diagnose spinal or extraspinal joint dysfunctions or neuro-musculoskeletal conditions. However, if during the course of a chiropractic spinal examination, we encounter non-chiropractic or unusual findings, we will advise you. If you desire advice, diagnosis, or treatment for those findings, we will recommend that you seek the services of another health care provider.
Regardless of what the disease is called, we do not offer to treat it. Nor do we offer advice regarding treatment prescribed by others. You give consent for the performance of such conservative, non-surgical treatment including, but not limited to, manipulation, physical therapy modalities, soft tissue massage, therapeutic exercise, acupuncture, cold laser therapy, or any other therapy that may be deemed necessary by the clinic.
I understand that there is no certainty that you will achieve benefits and acknowledge that no guarantee has been made regarding the outcome of these procedures. I also understand that of the alternatives to these procedures such as medications and/or surgery. I understand and accept that there are risks associated with chiropractic care and give your consent to the examinations that the chiropractor deems necessary, and to the chiropractic care, including spinal adjustments, as reported following assessment. I intend this consent to cover the entire course of care from all providers of Compass Mobile Chiropractic for my present condition and for any future condition(s) for which I seek chiropractic care from this office.
I certify with my signature that I have read, understand, agree to all of the above conditions.