They have always concerned themselves with the proper structure and function of the spine and nervous system. Even subtle changes in the spine are of concern to the Chiropractic Doctor. We treat the human spine with adjustments to remove subluxations.

Suppose that the spine has lost one of its normal curves, gained an extra curve, or that one or more of the bones has twisted out of its normal position. This change can have an effect on the spine, nerves, and the whole body. Chiropractics have termed these spinal changes "subluxations". A subluxation may cause pain, headaches, low back pain, leg pains, etc. Maybe it will show as numbness in the hand or foot. Perhaps it will be more subtle, nothing more than a lack of coordination or strength in the right leg, almost unnoticed. Or, with more subtlety, a reduction of local blood flow to the stomach, killing stomach lining cells, leading to ulcers. Spinal subluxations leading to ulcers? Yes.

Chiropractor Form:
Reason for Your Atlanta Chiropractors Visit

Name

Age

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Work Phone

Home Phone

FAX

E-mail

Occupation
Have you ever been treated by a Chiropractic before?
yes no
If so, please explain:
The reason for this visit is a result of:
work related accident sports injury auto accident trauma
chronic pain normal daily activity
Explain the pain/problem your having and it's location:
When did condition begin?
Is this condition getting worse?
yes no constant comes and goes
Is this condition interfering with your work, sleep, or daily routine? If so, please explain:
Have you had this or similar conditions in the past?
yes
no
If so, please explain:
Have you been treated by a Medical Physician for this condition?
yes
no
If so, where?
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YES

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**404.634.1669** *FAX: 404.634.1442*
Office Directions, Hours	FREE First Exam	Insurance Information
Headaches	New Patient Appointment Form	SCIATICA
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Neck Problems	Home	STRESS
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immediate care		buckhead urgent care centers		emergency care clinic		piedmont minor emergency
physicians immediate medical care		urologist		Plastic Surgeons		urologists
clinic		hypnosis		urgent care		immediate	Dallas
Jesitta-Hagan		orthopedics	clinics	orthopedic		orthopaedics	Acworth
emergency dentists		Alpharetta	spider	emergency medicine		Urgent Care	Smyrna
allergist	varicose	Optometrists Gwinnett		allergists	Stockbridge	compound	Austell
specialist	specialists	dermatology Alpharetta		management	Kennesaw	clinics	centers
hypnotists	Dentists	Dentists	std	pain center	pain centers	auto accidents specialists	auto accident specialist
Ga	emergency dentists	Georgia				emergency dentists

Dr. Simon is nationally and state Board Certified and has been practicing since 1992. He is extensively trained in many techniques such as Gonstead, Motion Palpation, Thompson, Pierce, Activator, HIO, and S.O.T. uses state of the art diagnostic and therapeutic equipment and we have a massage therapist Buckhead on staff chiropractic
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Name
Age
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail
Occupation

They have always concerned themselves with the proper structure and function of the spine and nervous system. Even subtle changes in the spine are of concern to the Chiropractic Doctor. We treat the human spine with adjustments to remove subluxations.

Chiropractor Form: Reason for Your Atlanta Chiropractors Visit

Chiropractor Form:
Reason for Your Atlanta Chiropractors Visit