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            CALL (530)222-4745 TO SCHEDULE AN APPOINTMENT. 
            You may also want to request a free 10 to 15 minute phone consultation.   Please specify when you speak to the office person or when you leave a message.   If you leave a message, we will get back to you as promptly as   possible. 
             
            PAPER WORK:  
            When you come to the office ,   there will be several forms and questionnaires to fill out and sign. Some are   general , while others are specific to your condition, such as those for   automobile accident cases. Bring insurance cards and information with you. You   may also request that we pre-clarify your insurance coverage before you come in.
            In the future will we will have our intake forms on the web site for you to   download and fill out at home. Please use a medium or heavier black pen. Date   the paper work when you are in the office on your first visit. 
            We may want to be able to consult with your family physician if needed. We   may also need to get records such as previous x-rays. Having names , phone   numbers and addresses will be helpful.  
            REGARDING MEDICATIONS AND   SUPPLEMENTS:  
            A complete list including dosage milligrams, time of   day, expected duration of Prescription etc. would also be helpful.
            CAUTION: IF YOU RECOGNIZE YOUR CONDITION AS TRAUMA RELATED ,   WHETHER PHYSICAL OR OTHERWISE, PLEASE TAKE YOUR TIME LOOKING THROUGH THIS   MATERIAL!  
            E.G.. AUTO ACCIDENTS CAN HAVE FAR REACHING EFFECTS. 
            E.G.. VARIOUS TYPES OF TRAUMAS CAN LEAVE THE BODY MIND AND SPIRIT WITH A WIDE   VARIETY OF PROBLEMS . 
            IF YOU RECOGNIZE THE ABOVE SCENARIO FITTING YOU , YOU MAY WANT TO GO TO ONE   OR MORE OF THE FOLLOOWING WEB PAGES FOR MORE INFORMATION: 
            www.traumasolutions.com - Diane Poole   Heller PhD. has written an excellent self help book for auto accident survivors   which can be used for other traumas.  
            www.traumahealing.com - Peter Levine   PhD. is the developer of Somatic experiencing. My web page will have more on the   system later.  
            Please refer to an article by Babette Rothschild, MSW, LCSW, "Applying the   Brakes" on her website and click on   Publications. 
            Auto Accident Recovery - For more information and a downloadable guide for what to do in case of an auto accident.  
            The following is a list of questions you are likely to be asked when Dr.   Evans takes an oral history: 
            On our intake forms, there will be a list of various possible symptoms for   you to choose from, but you may choose to list your symptoms in advance of your   visit by printing neatly in black on an 8-1/2 by 11 inch sheet of white paper   (the size of your typical computer paper) or printing something on your   computer. Our office list starts with areas of the body that might have pain. It   starts at the head and goes down to the feet. We also ask about thing like   digestion , depression fatigue and sleep patterns. YOU MAY WANT to FOLLOW THE   SAME PATTERN.  
            PLEASE NOTE OR BE PREPARED TO TELL THE DOCTOR IF YOU HAVE ANY SPECIFIC   CONDITION THAT ANOTHER CHIROPRACTOR OR OTHER DOCTOR HAS DIAGNOSED. 
            The Doctor will look at your list of symptoms. She will ask you if you have   any other conditions which you consider unrelated or which you don't considerer   to be a problem because you are taking medication to control the symptoms. The   answers to these questions help her get a well rounded picture of your situation   and may help you make some connections regarding various events and   symptoms. 
            LOCATION 
            1. Which symptom/problem do you find   the most difficult to deal with. (This could be because of pain or because it   limits your life style ). If this is a physical pain or problem we will note a   location.
            ONSET 
              2. When did this problem/symptom begin? Sometimes   the condition has been going on for a long time , in which case there might be a   Long term i.e. CHRONIC ONSET and an ACUTE ONSET (time that it recently started   to bother you again.) PLEASE NOTE: sometimes a pain can feel like the same old   pain you had last year, but in fact it is from another condition. The doctors   job is to help you understand this and get to the present cause whether is it is   the same old thing or something new aggravation the old problem or causing   similar feelings.  
            INTENSITY 
              3. On a scale of zero to ten, with zero being   nothing and ten being the worst, could you tell me the number you would give to   this problem when it has been at its worst. I.E.G... If there is neck pain when   it was it's most painful since the beginning of your problem, what is the   highest number on the zero to ten scale that you would give to this pain. 
            4. Regarding your pain and difficulty in dealing with your problem in the   last few weeks, what is the maximum number on the zero to ten scale you would   assign?  
            5. Can you assign a number on the zero to ten scale for how you are feeling   regarding this problem right now? 
            E.g.. If there is neck pain, do you feel it just sitting there or does it   happen when you move? 
            FREQUENCY 
            6. How often do you get   this problem? e.g. daily, weekly , monthly, constant, (including difficulty   sleeping or turning in bed) several times a day, daily but only really bad one   or two times a week. THERAPIES PREVIOUSLY ATTEMPTED OR IN PROGRESS.... FOR BETTER OR   WORSE 
            7. What kinds of things have you tried to help your condition,   e.g., home remedies, doctor's prescriptions, exercise programs, over the counter   medications, nutritional programs.
            8. What has worked the best? 
            9. Has there been anything that you've tried that has made you feel worse?  
            PERSONAL ASSESSMENT REGARDING OUTCOME OF THIS TREATMENT   PROTOCOL 
            10. How do you feel about your condition regarding your   recovery? E.g. Very optimistic , I 've heard good reports from other patients.   Not very hopefull , but I figure it's worth a try.
            The above questions are to give you an idea of how a history might go. Some   conditions work better than others for this format. I like to think that I am   always open to explore in a way that feels most comfortable to the person I'm   interviewing. If the above questions fit for your condition , feel free to write   or type your answers and bring them in. 
            The questions may be asked regarding each of you separate conditions or we   may focus on one or two for the 1st session. 
            PHONE   CONSULTATIONS 
            If you are going to have a phone consultation and your   weight is a problem, we would like you to advise us of your height and weight.   At the office, we have a scale which can calculate your body/fat ratio, based   upon your height (which is input into the scale) and your weight. We will also   want your age and birth date.
            If it is other than a 10 minute initial consultation , you will need to   clarify your form of payment in advance. 
            I hope that the above information is helpful.  
            Sincerely, 
            Dr Stephanie Evans (DC and RPP) 
              
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