{"id":6235,"date":"2026-02-14T07:16:10","date_gmt":"2026-02-14T07:16:10","guid":{"rendered":"https:\/\/www.slaterchirocare.com\/?page_id=6235"},"modified":"2026-02-14T07:22:50","modified_gmt":"2026-02-14T07:22:50","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/www.slaterchirocare.com\/index.php\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"6235\" class=\"elementor elementor-6235\">\n\t\t\t\t        <section class=\"elementor-section elementor-top-section elementor-element elementor-element-26d4689 elementor-reverse-mobile elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default ct-header-fixed-none ct-row-max-none\" data-id=\"26d4689\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;stretch_section&quot;:&quot;section-stretched&quot;}\">\n                            <div class=\"elementor-background-overlay\"><\/div>\n                \n                        <div class=\"elementor-container elementor-column-gap-default \">\n                    <div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-bac90db\" data-id=\"bac90db\" data-element_type=\"column\">\n        <div class=\"elementor-widget-wrap elementor-element-populated\">\n                    \n                <section class=\"elementor-section elementor-inner-section elementor-element elementor-element-05bd7b2 elementor-section-boxed elementor-section-height-default elementor-section-height-default ct-header-fixed-none ct-row-max-none\" data-id=\"05bd7b2\" data-element_type=\"section\">\n            \n                        <div class=\"elementor-container elementor-column-gap-default \">\n                    <div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-44ae43f\" data-id=\"44ae43f\" data-element_type=\"column\">\n        <div class=\"elementor-widget-wrap elementor-element-populated\">\n                    \n        \t\t<div class=\"elementor-element elementor-element-9d1de6b elementor-widget elementor-widget-heading\" data-id=\"9d1de6b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 05-08-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h1 class=\"elementor-heading-title elementor-size-default\">Chiropractic Care & Wellness Center<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3fdb462 elementor-widget elementor-widget-text-editor\" data-id=\"3fdb462\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 05-08-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<div class=\"colData__container logo__container \"><div class=\" logo_header__container--inner logo__container--inner\" data-component-name=\"logo_header\" data-component-alias=\"logo_header\" data-widget-alias=\"SMB__Logo__Widgets__LogoSettings___logo_header\" data-widget-id-base=\"LogoSettings-SMB__Logo__Widgets__LogoSettings___logo_header\" data-component-prop-coldata=\"\"><div class=\"logo \"><div class=\"logo__summary\"><p class=\"logo__description\"><em><span style=\"color: #ffffff;\">Dr. Jan Slater, D.C.<\/span><\/em><br \/><em><span style=\"color: #ffffff;\">Seekonk Activator Spine Specialist<\/span><\/em><\/p><\/div><\/div><\/div><\/div><p><span style=\"color: #ffffff;\">We Can See You Today&#8230;We Can Help You Today!<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t            <\/div>\n        <\/div>\n                <div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-fc23524\" data-id=\"fc23524\" data-element_type=\"column\">\n        <div class=\"elementor-widget-wrap elementor-element-populated\">\n                    \n        \t\t<div class=\"elementor-element elementor-element-2e44531 elementor-shape-circle e-grid-align-right elementor-grid-0 elementor-widget elementor-widget-social-icons\" data-id=\"2e44531\" data-element_type=\"widget\" data-widget_type=\"social-icons.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 05-08-2024 *\/\n.elementor-widget-social-icons.elementor-grid-0 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.elementor-icon.elementor-social-icon{border-radius:10%}.elementor-shape-circle .elementor-icon.elementor-social-icon{border-radius:50%}<\/style>\t\t<div class=\"elementor-social-icons-wrapper elementor-grid\">\n\t\t\t\t\t\t\t<span class=\"elementor-grid-item\">\n\t\t\t\t\t<a class=\"elementor-icon elementor-social-icon elementor-social-icon-facebook elementor-repeater-item-92337c6\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-screen-only\">Facebook<\/span>\n\t\t\t\t\t\t<i class=\"fab fa-facebook\"><\/i>\t\t\t\t\t<\/a>\n\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<span class=\"elementor-grid-item\">\n\t\t\t\t\t<a class=\"elementor-icon elementor-social-icon elementor-social-icon-youtube elementor-repeater-item-19cb616\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-screen-only\">Youtube<\/span>\n\t\t\t\t\t\t<i class=\"fab fa-youtube\"><\/i>\t\t\t\t\t<\/a>\n\t\t\t\t<\/span>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ca14823 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"ca14823\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<link rel=\"stylesheet\" href=\"https:\/\/www.slaterchirocare.com\/wp-content\/plugins\/elementor\/assets\/css\/widget-icon-list.min.css\">\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"flaticon flaticon-add-location-point\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">1563 Fall River Ave, Suite #3  Seekonk, MA 02771<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"flaticonv7 flaticonv7-phone-call-2\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">508-336-5582<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t            <\/div>\n        <\/div>\n                    <\/div>\n        <\/section>\n                    <\/div>\n        <\/div>\n                    <\/div>\n        <\/section>\n                <section class=\"elementor-section elementor-top-section elementor-element elementor-element-7384a77 elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default ct-header-fixed-none ct-row-max-none\" data-id=\"7384a77\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n            \n                        <div class=\"elementor-container elementor-column-gap-default \">\n                    <div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-3dce27e\" data-id=\"3dce27e\" data-element_type=\"column\">\n        <div class=\"elementor-widget-wrap elementor-element-populated\">\n                    \n        \t\t<div class=\"elementor-element elementor-element-f55c882 elementor-align-center elementor-widget elementor-widget-ct_button\" data-id=\"f55c882\" data-element_type=\"widget\" data-widget_type=\"ct_button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"ct-button-wrapper ct-button-layout1 icon- btn--inline \">\r\n            <span class=\"ct-icon-active\"><\/span>\r\n        <a href=\"https:\/\/www.slaterchirocare.com\/wp-content\/uploads\/2026\/02\/Health-History-Form-2026.pdf\" target=\"_blank\" class=\"btn btn-default icon-active btn-inline-block  \" data-wow-delay=\"ms\">\r\n                            <span class=\"ct-button-icon ct-align-icon-\">\r\n                            <\/span>\r\n                <span class=\"ct-button-text\">Update Health History (existing patients only)<\/span>\r\n    <\/a>\r\n<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-db314a8 elementor-align-center elementor-widget elementor-widget-ct_button\" data-id=\"db314a8\" data-element_type=\"widget\" data-widget_type=\"ct_button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"ct-button-wrapper ct-button-layout1 icon- btn--inline \">\r\n            <span class=\"ct-icon-active\"><\/span>\r\n        <a href=\"https:\/\/www.slaterchirocare.com\/wp-content\/uploads\/2026\/02\/Tablet-Lower-Back.pdf\" target=\"_blank\" class=\"btn btn-default icon-active btn-inline-block  \" data-wow-delay=\"ms\">\r\n                            <span class=\"ct-button-icon ct-align-icon-\">\r\n                            <\/span>\r\n                <span class=\"ct-button-text\">Pain Tablet Lower Back<\/span>\r\n    <\/a>\r\n<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t            <\/div>\n        <\/div>\n                <div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-4f0040a\" data-id=\"4f0040a\" data-element_type=\"column\">\n        <div class=\"elementor-widget-wrap elementor-element-populated\">\n                    \n        \t\t<div class=\"elementor-element elementor-element-504619d elementor-align-center elementor-widget elementor-widget-ct_button\" data-id=\"504619d\" data-element_type=\"widget\" data-widget_type=\"ct_button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"ct-button-wrapper ct-button-layout1 icon- btn--inline \">\r\n            <span class=\"ct-icon-active\"><\/span>\r\n        <a href=\"https:\/\/www.slaterchirocare.com\/wp-content\/uploads\/2026\/02\/NPDI-pdf.pdf\" target=\"_blank\" class=\"btn btn-default icon-active btn-inline-block  \" data-wow-delay=\"ms\">\r\n                            <span class=\"ct-button-icon ct-align-icon-\">\r\n                            <\/span>\r\n                <span class=\"ct-button-text\">Neck Pain Disability Index Questionnaire<\/span>\r\n    <\/a>\r\n<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6415314 elementor-align-center elementor-widget elementor-widget-ct_button\" data-id=\"6415314\" data-element_type=\"widget\" data-widget_type=\"ct_button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"ct-button-wrapper ct-button-layout1 icon- btn--inline \">\r\n            <span class=\"ct-icon-active\"><\/span>\r\n        <a href=\"https:\/\/www.slaterchirocare.com\/wp-content\/uploads\/2026\/02\/Tablet-Neck.pdf\" target=\"_blank\" class=\"btn btn-default icon-active btn-inline-block  \" data-wow-delay=\"ms\">\r\n                            <span class=\"ct-button-icon ct-align-icon-\">\r\n                            <\/span>\r\n                <span class=\"ct-button-text\">Pain Tablet Neck<\/span>\r\n    <\/a>\r\n<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t            <\/div>\n        <\/div>\n                    <\/div>\n        <\/section>\n        \t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Chiropractic Care &#038; Wellness Center Dr. Jan Slater, D.C.Seekonk Activator Spine Specialist We Can See You Today&#8230;We Can Help You Today! Facebook Youtube 1563 Fall River Ave, Suite #3 Seekonk, MA 02771 508-336-5582 Update Health History (existing patients only) Pain Tablet Lower Back Neck Pain Disability Index Questionnaire Pain Tablet Neck<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6235","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.slaterchirocare.com\/index.php\/wp-json\/wp\/v2\/pages\/6235","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.slaterchirocare.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.slaterchirocare.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.slaterchirocare.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.slaterchirocare.com\/index.php\/wp-json\/wp\/v2\/comments?post=6235"}],"version-history":[{"count":10,"href":"https:\/\/www.slaterchirocare.com\/index.php\/wp-json\/wp\/v2\/pages\/6235\/revisions"}],"predecessor-version":[{"id":6271,"href":"https:\/\/www.slaterchirocare.com\/index.php\/wp-json\/wp\/v2\/pages\/6235\/revisions\/6271"}],"wp:attachment":[{"href":"https:\/\/www.slaterchirocare.com\/index.php\/wp-json\/wp\/v2\/media?parent=6235"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}