Please complete this form prior to your appointment so that we may tailor your therapy to suit.

The human body is designed to be healthy. Throughout life, events occur which damage your health expression. This case history will uncover the layers of damage, especially to your nerve system, which have resulted in poor health. Spinal Flow will begin to correct these layers of damage and recover your innate health potential.

Let’s begin at birth when you may have first damaged your nerve system, lost your wellness and began your journey to ill health.

As you increase the layer of damage you probably begin to experience symptoms and random bouts of sickness.

By submitting this form, I agree and consent to the healing work while I am on this program. I understand that with any healing process and work on my body, my symptoms may worsen before they get better. I understand this program is designed to assist the body with healing by helping to remove stressors from the body. I understand that healing takes time and there is no quick immediate fix to my problem, and health is a process. I have freely decided to undergo the recommended treatment and hereby give my full consent to treatment. I take full responsibility for my health and any unforeseen circumstances while I am on this program.