Informed Consent: 

Doctors of Chiropractic who use manual therapy techniques such as spinal adjustment or manipulation or mobilization, are advised to inform patients that there may be some risks associated with such treatment.  In particular:

• While rare, some patients have experienced muscle soreness, ligament sprains and strains, general aggravations of an inflammatory nature or rib fractures following spinal adjustments.
• There have been reported cases of injury to a vertebral artery following neck adjustment, manipulation and\or mobilization.  Vertebral artery injuries may cause a stroke, sometimes with serious neurological impairment.  This form of complication resulting from cervical spinal adjustments is extremely rare.
• There have been rare reported cases of disc injuries following spinal manual therapy, although no scientific study has ever demonstrated that such injuries are caused, or may be caused by spinal adjustment or manipulative techniques.

Chiropractic treatment, including spinal adjustment has been the subject of much research conducted over many years and has been demonstrated to be an appropriate and effective treatment for many common forms of spinal pain, headaches, and other similar symptoms. Treatment provided at this clinic may also contribute to your overall well-being.  The risk of injury or complication from manual therapy is substantially lower than the risk associated with medicine and other treatments and procedures frequently given as alternatives for the same form of musculoskeletal pain and associated syndromes.

I acknowledge I have discussed, or have been given the opportunity to discuss, with my chiropractor the nature and purpose of chiropractic treatment in general and my treatment in particular as well as the contents of this consent.  I understand that the doctor will examine and evaluate my condition in order to minimize any risk. I do not expect the doctor to be able to anticipate and explain all risks and complications and I therefore wish to rely on the doctor or associate to exercise their judgment during the course of such procedures, based upon the facts then known, and considered in my best interest.

I consent to the treatments offered or recommended to me by my chiropractor or her associates, including joint adjustment or manipulation to the joints of my spine, pelvis and extremities.  I intend this consent to apply to all my present and future treatments at this clinic.