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Progress Evaluation #2
Step
1
of
14
7%
Name
*
First
Last
What positive changes have you noticed with your overall health since starting your correction programme?
*
What
positive changes
have you noticed with your
overall health
since starting your
correction programme
?
Better sleep
Increased energy
Improved mood
Less pain / discomfort
Better focus / concentration
Improved digestion
Improved posture
More mobility / flexibility
Fewer headaches
Greater freedom of movement
Improved balance
On a scale of 1 to 10, rate your TOTAL HEALTH level of improvement
*
On a scale of 1 to 10, rate your
TOTAL HEALTH
level of improvement
What are the 3 legs of "The 3 Legged Stool of Correction"?
*
What are the 3 legs of
"The 3 Legged Stool of Correction"
?
Nutrition
Adjustments in rhythm
Laughter
Sleep patterns
Breaking bad habits
Correction exercises
What is the name of the condition of the spine that interferes with the transmission of the nerve messages from your brain to your body?
*
What is the name of the
condition of the spine
that
interferes
with the transmission of the
nerve messages
from your brain to your body?
Scoliosis
Herniated disc
Subluxation
Arthritis
Spinal decay
Slipped disc
What does an Adjustment do? (tick all that apply)
What does an
Adjustment
do? (tick all that apply)
Restores correct alignment of the spine
Removes inflamation in muscles and ligaments
Reduces and prevents spinal decay
Decreases stress in the nervous system
Improves posture and balance
Enhances brain to body connection
Boosts the immune system
What percentage of the 'Master Control System' perceives pain?
*
What percentage of the
'Master Control System'
perceives pain?
0%
5%
10%
20%
100%
How are you doing with keeping your scheduled appointments in rhythm?
*
How are you doing with keeping your
scheduled appointments
in
rhythm
?
Do you know what bad habits you have that are limiting your progress?
*
Do you know what
bad habits
you have that are
limiting
your
progress
?
Yes
No
How are you doing with breaking your bad habits?
*
How are you doing with
breaking
your
bad habits
?
Do you know what correction exercises you should be doing to support your adjustments?
*
Do you know what
correction exercises
you should be doing to
support your adjustments
?
Yes
No
How are you doing with your correction exercises? (grade yourself)
*
How are you doing with your
correction exercises
? (grade yourself)
What could you do to get better results and reach your goals?
*
What could
you
do to get
better results
and
reach your goals
?
Maintain scheduled adjustments in rhythm
Only get adjusted when in pain
Stop when symptoms improve
Improve nutrition
Be consistent with sleep times
Keep active
Wait and see if things improve on their own
Please select who you would like to help at this point in time
Please select who you would
like to help
at this point in time
Spouse
Children
Grandchildren
Brothers / sisters
Parents
Friends
Grandparents
Work colleague