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Progress Evaluation #4
Step
1
of
14
7%
Name
*
First
Last
Do you understand the Doctor’s recommendations for your correction programme?
*
Do you understand the
Doctor’s recommendations
for your
correction programme
?
Yes
No
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 ?
*
How are you doing with your
correction exercises
?
How many online MasterClasses have you attended?
How many online
MasterClasses
have you attended?
1
2
3
4
5
6
7
8
9
10
The 3 causes of Subluxation - Traumas, Toxins and Thoughts What Physical stress (Traumas) causes Subluxation?
*
The 3 causes of Subluxation -
T
raumas,
T
oxins and
T
houghts
What
Physical stress
(
T
raumas) causes Subluxation?
The 3 causes of Subluxation - Traumas, Toxins and Thoughts What Chemical stress (Toxins) causes Subluxation?
*
The 3 causes of Subluxation -
T
raumas,
T
oxins and
T
houghts
What
Chemical stress
(
T
oxins) causes Subluxation?
The 3 causes of Subluxation - Traumas, Toxins and Thoughts What Mental stress (Thoughts) causes Subluxation?
*
The 3 causes of Subluxation -
T
raumas,
T
oxins and
T
houghts
What
Mental stress
(
T
houghts) causes Subluxation?
What does it mean when the head, shoulders and hips are unlevel?
*
What does it mean when the
head
,
shoulders
and
hips
are
unlevel
?
Drunk?
Brain is out of balance
Posture is out of alignment
A broken bone
Caused by genetics
What other areas of your health would you like help with?
*
What other areas of
your health
would you like help with?
Fitness
Physical condition
Weight
Nutritional intake
Hormones
Digestion
Mental resilience
Balance
Sleep
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
