Commonwealth Chiropractic of Boston, 480 Washington Street, Brighton, MA 02135, TEL: 617-739-0046

Informed Consent

Chiropractic Healthcare involves various techniques and modalities to achieve the best possible outcome for the patient. These include, but are not limited to the following:

1. Chiropractic Adjustment/Manipulation: A chiropractic therapeutic maneuver that utilizes controlled force, leverage, direction, amplitude, and velocity and which is directed at specific joints or anatomical regions. Chiropractors commonly use such procedures to influence joint and neurophysiologic function.

2. Electro-Therapy: A therapeutic treatment to aid in the relief of pain and promotion of soft tissue healing. Also causes stimulation of innervated muscle to cause contraction, which helps force fluid out of the lymphatic and interstitial tissues thereby reducing edema. Also helps stimulate the release of endorphins, which are the body's natural painkillers.

3. Myofascial Release Technique: Relaxes overactive muscles in and helps stretch chronically shortened muscles. Helps restore normal elasticity to the muscles, ligaments and tendons.

4. Manual Traction: Involves a force acting on a longitudinal axis to draw structures apart. Induces passive motion into the spine for the purpose of stretching spinal joints and increasing mobility.

5. Ultrasound: Sound vibrations penetrate the soft tissues deep in the body creating heat response. These vibrations and heat break down and disperse unhealthy calcium, adhesions and other hard tissue accumulations within the muscles, ligaments and tendons.

6. Microcurrent Therapy: Uses extremely small amounts of electrical current to help relieve pain and heal soft tissues of the body. Injury to the body disrupts its normal electrical activity. Microcurrent produces electrical signals like those naturally occurring when the body is repairing damaged tissues. By applying similar electrical currents, the healing process is enhanced.

7. Mobilization: Movement applied singularly or repetitively within or at the physiologic range of joint motion, with out imparting a thrust or impulse, wit the goal of restoring joint mobility.

It is common for chiropractic adjustments, traction, massage therapy, exercise, etc. to result in a temporary increase in soreness in the region being treated. This is nearly always a temporary symptom that occurs while your body is undergoing therapeutic change. It is not dangerous, but please do tell your treating chiropractic physician about it.

Chiropractic is a system of healthcare delivery, and, therefore, as with any healthcare delivery system cannot produce a cure for any symptom, disease or condition as a result of treatment at this facility.

I have been informed that I have the right to refuse any form of treatment. I understand the nature of the treatment, and been informed of the risks and possible consequences involved with this treatment, and I understand that I will be given the opportunity to ask questions at every stage of my treatment. I also understand that there is always the possibility of an unexpected complication and I understand that no guarantee can be made concerning the results of treatment.