Types of care questionnaire

Add up the points of your answers to the questions below to helps us choose which is the most recommended type of care for you:

Structural care: Total of 11-20 points
Structural+ care: Total of 19-28 points
Complete care: Total of 27-33 points

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  1. How long have you been suffering from health problems
    • 0-6 months (1 point)
    • 6-18 months (2 points)
    • Over 18 months (3 points)
  2. How many health issues/conditions/disturbance do you experience
    • 1 (1 point)
    • 1-3 (2 points)
    • Over 3 (3 points)
  3. Your objective from care with me is:
    • Get rid of my pain (1 point)
    • Improve my function (2 points)
    • Optimize my health to the best of my ability (3 points)
  4. How important is your health to you?
    • Not too important (1 point)
    • Somewhat important (2 points)
    • Very important (3 points)
  5. Are you committed to making lifestyle changes to improve your overall health?
    • Not really (1 point)
    • I’m willing to make some changes (2 points)
    • Yes, I’m fully committed (3 points)
  6. How would you describe the complexity of your health concerns?
    • Mild (1 point)
    • Moderate (2 points)
    • Severe (3 points)
  7. How interested are you in exploring additional therapy techniques beyond traditional chiropractic adjustments?
    • Not interested (1 point)
    • Somewhat interested (2 points)
    • Very interested (3 points)
  8. Do you experience discomfort or issues beyond the spine and pelvis, such as in the extremities or jaw?
    • No (1 point)
    • Occasionally (2 points)
    • Yes, frequently (3 points)
  9. Have you previously sought chiropractic or other alternative healthcare treatments?
    • No (1 point)
    • Yes, occasionally (2 points)
    • Yes, regularly (3 points)
  10. Are you looking for a comprehensive approach that considers not only structural health but also emotional and biochemical factors?
    • No, I prefer a focus solely on physical health (1 point)
    • Somewhat, I’m open to considering other factors (2 points)
    • Yes, I’m interested in a holistic approach (3 points)
  11. Are you currently experiencing any emotional or psychological stressors?
    • No (1 point)
    • Occasionally (2 points)
    • Yes, frequently (3 points)
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