_____________________________________ Monahan Chiropractic PA Stephen Monahan, D.C. 4022 Blanding Blvd. Jacksonville, FL 32210 Phone: 904-778-7963 ________________________________ Home About Us Health Survey Office Hours Patient Testimonials What To Expect Payment Options Contact us ________________________________ Chiropractic Topics ________________________________ Why Patients Consult Our Office Could Chiropractic Help You? Chiropractic VS. Medical Treatment Types of Chiropractic Care What are Subluxations ? Chiropractic Adjustments History of Chiropractic Glossary of Chiropractic Terms Frequently Asked Questions Celebrity Chiropractic Patients How to Become a Patient ________________________________  • Arthritis  • Auto Accidents  • Back Pain  • Carpal Tunnel  • Chiro & Workers' Comp.  • Exercise and Physical Fitness  • Headaches  • Health and Wellness  • Hip Pain  • Infants Health Issues  • Muscle Spasms  • Numbness  • Nutrition and Balanced Diet  • Pinched Nerve  • Pregnancy  • Sciatica  • Scoliosis  • Slipped disc  • Stress  • Whiplash  • Whole Body Health ________________________________ Special Promotion                     Email Doctor                                 Subscribe To Our Newsletter   Email This Page To Your Friend           Make Blanding Chiropractic My Home Page

Health Survey Please complete the following form if you would like to be contacted by our clinic. To assist the doctor we kindly ask that you be as thorough as possible. If you would like to schedule an initial consultation, please call us. Thank you. Name: Age: Street: City: State: Zip: Phone: Gender: male female Email: Auto accident related: Yes No Work accident related: Yes No Headaches: Yes No Fatigue: Yes No Weakness: Yes No Irritability: Yes No Neck Pain: Yes No Nervousness: Yes No Numbness: Yes No Trouble Sleeping: Yes No Low Back Pain: Yes No Dizziness: Yes No Tingling: Yes No Allergies: Yes No Joint Pain: Yes No Pain Between Shoulder Blades: Yes No Digestive Problems: Yes No What bothers you the most: Duration of difficulty: Additional comments: Chiropractic can help the above listed conditions many times because Chiropractic Doctors gently treat the body, naturally, without drugs to remove the stress and imbalances that cause health problems.

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