Orientation Quiz
1. What controls and coordinates all the functions in
your body? _________________________________
2. What is it called when the spine is misaligned?
A V_______________ S__________________
3. Is the purpose of an adjustment to make the body
Heal better or Feel better? __________________
4. Do Chiropractors:
Adjust subluxations or Treat pain? (circle one)
5. What are 3 ways a Chiropractor can find a
Subluxation?________________________________
___________________________________________
6. What causes a Subluxation? _________________
7. How often does the research show we should be
checked for subluxations? ____________________
7. Name 4 things you can do to keep you and your
family healthy: _________________ Well
_________________ Well
_________________ Well
Stay Well __________________
(continued on page 2)
8. What are the 3 rules for using the Box or
Membership for payment in the office?
1.________________________________
2.________________________________
3.________________________________
9. What happens if we do not see you for more than
14 days?
9. What is the fee if it has been more than 14 days
since your last visit?___________
I ____________________ hereby testify that I have
watched the online orientation and understand the
purpose of chiropractic, how often to be checked for
vertebral subluxations in the office, where to go when
I have a medical symptom, and the rules for the
honor box and monthly membership if I decide to use
it.
Signed____________________________________
Date______________________________________