Align Chiropractic Event Consent Form
I consent to a stretch and posture analysis scan as part of my visit. I understand this gentle, non‑invasive assessment helps identify how my body is moving and where support may be needed so my care can be personalized.
This is for evaluation purposes only, and will help my provider assess my posture, mobility, and areas of muscular tension. I acknowledge that I may decline or stop the assessment at any time.
First Name
Last Name
PHONE NUMBER
EMAIL ADDRESS
Have you seen a chiropractor before?
How long ago did you last see a chiropractor?
Any specific issue you want us to address today?
Consent to be evaluated today (Print Full Name.)