Test Client Registration Form

Client Background

Client History Forms and PDF Documents
  • MM slash DD slash YYYY
  • Medical Information

  • List accidents/injuries, hospitalizations, and surgeries: when they occurred and treatment received.
  • Any lingering effects from the above or do you feel that you have recovered?
  • If yes please describe and any care or treatment your receive.
  • If yes please describe.
  • If yes please describe.
  • This field is for validation purposes and should be left unchanged.
Start Feeling Better Today​

Join The Making Shifts Happen Community

Are you stuck in chronic pain, illness or stress? Do you really want to break that cycle of unrelenting stress? Talk with Dr Steph and you can start feeling better today?

WPGrow