[et_pb_section fb_built=”1″ fullwidth=”on” _builder_version=”4.21.0″ _module_preset=”default” bottom_divider_color=”#FFFFFF” bottom_divider_height=”32px” bottom_divider_repeat=”1x” locked=”off” global_colors_info=”{}”][et_pb_fullwidth_header title=”@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF90aXRsZSIsInNldHRpbmdzIjp7ImJlZm9yZSI6IiIsImFmdGVyIjoiIn19@” text_orientation=”center” button_one_url=”http:\/\/stage.mvsj.com\/stage\/patient-forms\/” button_two_url=”http:\/\/stage.mvsj.com\/stage\/contact-us\/” _builder_version=”4.21.0″ _dynamic_attributes=”title” _module_preset=”default” title_font=”||||||||” title_text_align=”center” title_font_size=”60px” title_line_height=”1.1em” subhead_font=”Josefin Sans|||on|||||” subhead_font_size=”24px” subhead_line_height=”1.4em” background_enable_color=”off” use_background_color_gradient=”on” background_color_gradient_type=”elliptical” background_color_gradient_direction_radial=”bottom right” background_color_gradient_stops=”rgba(38,78,133,0.65) 51%|rgba(38,78,133,0.76) 100%” background_color_gradient_overlays_image=”on” background_image=”http:\/\/stage.mvsj.com\/stage\/wp-content\/uploads\/Banner-1920w.webp” parallax=”on” custom_button_one=”on” button_one_text_size=”16px” button_one_text_color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ button_one_bg_color=”gcid-6d2d926d-7e0e-41cb-a23c-27a251f2ded8″ button_one_border_color=”gcid-6d2d926d-7e0e-41cb-a23c-27a251f2ded8″ button_one_border_radius=”5px” button_one_font=”Roboto|||on|||||” button_one_use_icon=”off” button_one_custom_padding=”12px||12px||true|true” custom_button_two=”on” button_two_text_size=”16px” button_two_text_color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ button_two_bg_color=”#FFFFFF” button_two_border_color=”gcid-6d2d926d-7e0e-41cb-a23c-27a251f2ded8″ button_two_border_radius=”5px” button_two_font=”Roboto|||on|||||” button_two_use_icon=”off” button_two_custom_padding=”12px||12px||true|true” custom_padding=”7.6%||7.6%||true|false” title_font_size_tablet=”50px” title_font_size_phone=”35px” title_font_size_last_edited=”on|phone” subhead_font_size_tablet=”24px” subhead_font_size_phone=”16px” subhead_font_size_last_edited=”on|desktop” custom_css_button_1=”WIDTH: 30%;” custom_css_button_2=”WIDTH: 30%;” title_text_shadow_style=”preset5″ title_text_shadow_horizontal_length=”0.18em” title_text_shadow_vertical_length=”0.16em” title_text_shadow_blur_strength=”0.14em” box_shadow_style_button_one=”preset1″ box_shadow_style_button_two=”preset1″ global_colors_info=”{%22gcid-b2246a73-d8bc-4371-812f-c65167c7f989%22:%91%22button_one_text_color%22,%22button_two_text_color%22,%22button_two_text_color__hover%22%93,%22gcid-6d2d926d-7e0e-41cb-a23c-27a251f2ded8%22:%91%22button_one_bg_color%22,%22button_one_border_color%22,%22button_two_border_color%22,%22button_two_bg_color__hover%22,%22button_two_border_color__hover%22%93}” button_two_bg_color__hover_enabled=”on|hover” button_two_bg_color__hover=”#ffffff” button_two_bg_enable_color__hover=”on” button_two_border_color__hover_enabled=”on|hover” button_two_border_color__hover=”#ffffff” button_two_text_color__hover_enabled=”on|hover” button_two_text_color__hover=”#264e85″ custom_css_button_1_last_edited=”on|tablet” custom_css_button_1_phone=”WIDTH: 100%;” custom_css_button_2_last_edited=”on|phone” custom_css_button_2_phone=”WIDTH: 100%;” custom_css_button_1_tablet=”WIDTH: 50%;” custom_css_button_2_tablet=”WIDTH: 50%;”][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_row column_structure=”1_2,1_2″ module_id=”02″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”http:\/\/stage.mvsj.com\/stage\/wp-content\/uploads\/Office-1920w.webp” title_text=”Office-1920w” _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_image][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.21.0″ _module_preset=”default” text_text_color=”#000000″ header_2_font=”|700|||||||” header_2_text_color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ header_2_font_size=”37px” header_2_letter_spacing=”2px” header_2_line_height=”1.4em” header_4_text_color=”gcid-8ef3e1bc-ae2f-46de-b8f6-30caaf460e2c” header_4_font_size=”14px” animation_intensity_slide=”19%” header_2_letter_spacing_tablet=”2px” header_2_letter_spacing_phone=”1px” header_2_letter_spacing_last_edited=”on|tablet” custom_css_main_element=”font-weight: 400;” global_colors_info=”{%22gcid-8ef3e1bc-ae2f-46de-b8f6-30caaf460e2c%22:%91%22header_4_text_color%22%93,%22gcid-b2246a73-d8bc-4371-812f-c65167c7f989%22:%91%22header_2_text_color%22%93}”]<\/p>\n
We examine and treat on the first visit. Imaging, such as x-rays or MRI\u2019s, are only ordered if medically indicated or necessary.<\/p>\n
We ask that you please fill out new patient intake paperwork before your visit.<\/p>\n
If you have previous imaging, from within the past year, we ask that you bring that with you as well.<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_divider color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ divider_style=”double” divider_position=”center” divider_weight=”3px” _builder_version=”4.21.0″ _module_preset=”default” max_width=”39%” module_alignment=”center” global_colors_info=”{%22gcid-b2246a73-d8bc-4371-812f-c65167c7f989%22:%91%22color%22%93}”][\/et_pb_divider][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ module_id=”03″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.21.0″ _module_preset=”default” text_text_color=”#000000″ header_2_font=”|700|||||||” header_2_text_color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ header_2_font_size=”37px” header_2_letter_spacing=”2px” header_2_line_height=”1.4em” header_4_text_color=”gcid-8ef3e1bc-ae2f-46de-b8f6-30caaf460e2c” header_4_font_size=”14px” animation_intensity_slide=”19%” header_2_letter_spacing_tablet=”2px” header_2_letter_spacing_phone=”1px” header_2_letter_spacing_last_edited=”on|tablet” custom_css_main_element=”font-weight: 400;” global_colors_info=”{%22gcid-8ef3e1bc-ae2f-46de-b8f6-30caaf460e2c%22:%91%22header_4_text_color%22%93,%22gcid-b2246a73-d8bc-4371-812f-c65167c7f989%22:%91%22header_2_text_color%22%93}”]<\/p>\n
What to wear:<\/strong> Please bring:<\/strong> [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”http:\/\/stage.mvsj.com\/stage\/wp-content\/uploads\/manual-chiropractic-adjustments-2880w.webp” title_text=”manual-chiropractic-adjustments-2880w” _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_image][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.21.0″ _module_preset=”default” locked=”off” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_divider color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ divider_style=”double” divider_position=”center” divider_weight=”3px” _builder_version=”4.21.0″ _module_preset=”default” max_width=”39%” module_alignment=”center” global_colors_info=”{%22gcid-b2246a73-d8bc-4371-812f-c65167c7f989%22:%91%22color%22%93}”][\/et_pb_divider][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ module_id=”04″ _builder_version=”4.21.0″ _module_preset=”default” locked=”off” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”http:\/\/stage.mvsj.com\/stage\/wp-content\/uploads\/manual-chiropractic-adjustments-2880w.webp” title_text=”manual-chiropractic-adjustments-2880w” _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_image][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.21.0″ _module_preset=”default” text_text_color=”#000000″ header_2_font=”|700|||||||” header_2_text_color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ header_2_font_size=”37px” header_2_letter_spacing=”2px” header_2_line_height=”1.4em” header_4_text_color=”gcid-8ef3e1bc-ae2f-46de-b8f6-30caaf460e2c” header_4_font_size=”14px” custom_margin=”||6px|||” animation_intensity_slide=”19%” header_2_letter_spacing_tablet=”2px” header_2_letter_spacing_phone=”1px” header_2_letter_spacing_last_edited=”on|tablet” custom_css_main_element=”font-weight: 400;” global_colors_info=”{%22gcid-8ef3e1bc-ae2f-46de-b8f6-30caaf460e2c%22:%91%22header_4_text_color%22%93,%22gcid-b2246a73-d8bc-4371-812f-c65167c7f989%22:%91%22header_2_text_color%22%93}”]<\/p>\n Patient Intake Forms , HIPPA Financial Policy , Treatment of minors requires a team effort by the medical care provider(s) and the minor\u2019s parent or guardian.
\u2013 Normal clothes or work wear is acceptable.
\u2013 Preferably relaxed fit or free moving athletic clothing is the best.
\u2013 It is suggested if in dress clothes that a change of shirt\/shorts be brought with you.<\/p>\n
\u2013 Insurance ID and information
\u2013 State Issued ID<\/p>\nNew Patient Forms<\/span><\/h2>\n
\n Medical Records Release Form [\/et_pb_text][et_pb_button button_url=”@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wYWdlIiwic2V0dGluZ3MiOnsicG9zdF9pZCI6Ijk2In19@” button_text=”Patient Intake Form” button_alignment=”left” _builder_version=”4.21.0″ _dynamic_attributes=”button_url” _module_preset=”default” button_text_size=”12px” button_border_width=”0px” button_border_radius=”0px” button_letter_spacing=”2px” button_font=”|700||on|||||” custom_margin=”||5px||false|false” custom_padding=”18px|40px|18px|40px|true|true” custom_css_main_element=”width: 70%;||text-align: center;” locked=”off” global_colors_info=”{}” custom_css_main_element_last_edited=”on|phone” custom_css_main_element_phone=”width: 100%;||text-align: center;” custom_css_main_element_tablet=”width: 70%;||text-align: center;”][\/et_pb_button][et_pb_button button_url=”http:\/\/stage.mvsj.com\/stage\/wp-content\/uploads\/HIPPA-Financial-Policy.pdf” button_text=”HIPPA Financial Policy ” button_alignment=”left” _builder_version=”4.21.0″ _module_preset=”default” button_text_size=”12px” button_border_width=”0px” button_border_radius=”0px” button_letter_spacing=”2px” button_font=”|700||on|||||” custom_margin=”||5px||false|false” custom_padding=”18px|40px|18px|40px|true|true” hover_enabled=”0″ custom_css_main_element=”width: 70%;||text-align: center;” locked=”off” global_colors_info=”{}” custom_css_main_element_last_edited=”on|phone” custom_css_main_element_phone=”width: 100%;||text-align: center;” custom_css_main_element_tablet=”width: 70%;||text-align: center;” sticky_enabled=”0″][\/et_pb_button][et_pb_button button_url=”http:\/\/stage.mvsj.com\/stage\/wp-content\/uploads\/MedicalRecordsRelease.pdf” button_text=”Medical Records Release Form ” button_alignment=”left” _builder_version=”4.21.0″ _module_preset=”default” button_text_size=”12px” button_border_width=”0px” button_border_radius=”0px” button_letter_spacing=”2px” button_font=”|700||on|||||” custom_padding=”18px|40px|18px|40px|true|true” hover_enabled=”0″ custom_css_main_element=”width: 70%;||text-align: center;” locked=”off” global_colors_info=”{}” custom_css_main_element_last_edited=”on|phone” custom_css_main_element_phone=”width: 100%;||text-align: center;” custom_css_main_element_tablet=”width: 70%;||text-align: center;” sticky_enabled=”0″][\/et_pb_button][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.21.0″ _module_preset=”default” locked=”off” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_divider color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ divider_style=”double” divider_position=”center” divider_weight=”3px” _builder_version=”4.21.0″ _module_preset=”default” max_width=”39%” module_alignment=”center” global_colors_info=”{%22gcid-b2246a73-d8bc-4371-812f-c65167c7f989%22:%91%22color%22%93}”][\/et_pb_divider][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ module_id=”05″ _builder_version=”4.21.0″ _module_preset=”default” locked=”off” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.21.0″ _module_preset=”default” text_text_color=”#000000″ header_2_font=”|700|||||||” header_2_text_color=”gcid-b2246a73-d8bc-4371-812f-c65167c7f989″ header_2_font_size=”37px” header_2_letter_spacing=”2px” header_2_line_height=”1.4em” header_4_text_color=”gcid-8ef3e1bc-ae2f-46de-b8f6-30caaf460e2c” header_4_font_size=”14px” animation_intensity_slide=”19%” header_2_letter_spacing_tablet=”2px” header_2_letter_spacing_phone=”1px” header_2_letter_spacing_last_edited=”on|tablet” custom_css_main_element=”font-weight: 400;” global_colors_info=”{%22gcid-8ef3e1bc-ae2f-46de-b8f6-30caaf460e2c%22:%91%22header_4_text_color%22%93,%22gcid-b2246a73-d8bc-4371-812f-c65167c7f989%22:%91%22header_2_text_color%22%93}”]<\/p>\nConsent for Minors Form<\/span><\/h2>\n
\nThe parent or guardian\u2019s responsibility includes supporting the medical directives given by the medical provider.
\nThe medical provider\u2019s role includes ensuring that the parent or guardian is aware of and concurs with the
\ntreatment their child or children receives.[\/et_pb_text][et_pb_button button_url=”http:\/\/stage.mvsj.com\/stage\/wp-content\/uploads\/MVSJ-Consent-of-Minor.pdf” button_text=”Consent for Minors Form ” button_alignment=”left” _builder_version=”4.21.0″ _module_preset=”default” button_text_size=”12px” button_border_width=”0px” button_border_radius=”0px” button_letter_spacing=”2px” button_font=”|700||on|||||” custom_margin=”||5px||false|false” custom_padding=”18px|40px|18px|40px|true|true” hover_enabled=”0″ custom_css_main_element=”width: 70%;||text-align: center;” locked=”off” global_colors_info=”{}” custom_css_main_element_last_edited=”on|phone” custom_css_main_element_phone=”width: 100%;||text-align: center;” custom_css_main_element_tablet=”width: 70%;||text-align: center;” sticky_enabled=”0″][\/et_pb_button][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”http:\/\/stage.mvsj.com\/stage\/wp-content\/uploads\/manual-chiropractic-adjustments-2880w.webp” title_text=”manual-chiropractic-adjustments-2880w” _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ fullwidth=”on” _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_fullwidth_code _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”]