Pregnancy Health History Profile

Please read and complete to the best of your knowledge.

WELCOME and THANK YOU for applying as a patient to Healthy Kids & Family Chiropractic Centre!

Pregnancy is a normal physiological process that women go through to maintain the human race. It does not necessarily have to be difficult and challenging. Research shows that well-adjusted mothers have easier labour and healthier children. That’s exactly what we would like to see. Dr. Sokolov is trained and certified in Webster In-Utero Constraint Technique.

We are specialized in unique research-based neurological, spinal and postural rehabilitation that helps our patients recover optimal health by restoring normal nervous system function. Our treatments often succeed where other methods have failed.

Because of this, we may not accept you as a patient until we are absolutely certain that we know the cause of your condition. If we are able to treat you, we will conduct thorough testing in order to establish an optimal spinal reconstruction program for you. With this process, we are confident we will provide you with the best possible treatment for your condition.

It is of paramount importance for you to follow the doctor’s recommendations in order to recover. With your health as our TOP PRIORITY, we would love to accept you into our care at our centre.

We are looking forward to serving you –thank you again for applying as a patient.

Your answers to the following questions will give us a profile of the specific stresses you have faced in your lifetime, allowing us to better assess the challenges to your health. Please complete your Health History Profile in as much detail as possible – this will help the doctor reviewing your situation prior to your initial visit understand how to best serve you.

Research is showing that most of the health challenges that occur later in life have their origins during the developmental years, some starting at birth. Please answer the following questions to the best of your ability.
If Pain is PresentIndicate intensity by sliding the marker

Please check ALL of the following that YOU might have EVER had, even if you don’t think they are related to the current problem:
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