Georgia Chiropractic | 2315 Highway K, O'Fallon, MO 63368 | (636) 978-6995

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Informed Consent for Chiropractic Adjustments and Care

When you come to our office, you will be asked to sign an informed consent form for Chiropractic Adjustments & Care. 

You will hereby request and consent to the performance of Chiropractic procedures, including various modes of physical therapy and diagnostic x-rays by the doctors of chiropractic of your choice. 


You will have an opportunity to discuss with the doctor of chiropractic named below, and/or with other office or clinic personnel the nature and purpose of chiropractic adjustments and other procedures. Please understand that results are not guaranteed. 


You understand and are informed that, as with the practice of medicine chiropractic carries some risks to treatment, including, but not limited to fractures, disc injuries, strokes, dislocations and sprains. You should not expect the doctor to be able to anticipate and explain all risks and complications. You will knowingly consent to rely on the doctor’s best judgment, exercised during the course of treatment that is in your best interest, based upon the known facts.

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