Schumacher Chiropractic Clinics, P.A.
A Family of Chiropractic Care for over 29 years
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Patient Questionnaire
If your score is 3 or above, please contact us to setup an initial consultation

Request an appointment


Special Offer:

Free Initial Consultation

for new patients 

Read what our patients have to say...

"Dr Bill put me at ease immediately during the initial consultation. The best part is that I walked out feeling 100% better...and remained in good health going forward.
" - Todd G. read more... 

Do you need a chiropractor?

Answer our short and easy questionnaire below. Pick the one statement that most closely describes your problem.

PAIN INTENSITY

  1. I have no pain.
  2. I can tolerate the pain without drugs.
  3. I can manage my pain with the help of drugs.
  4. Pain relievers give me no comfort.

LIFTING

  1. I have no pain when lifting.
  2. I have slight pain when I lift.
  3. Pain prevents me from lifting heavy objects.
  4. I can only lift light to moderate objects.
  5. I can barely lift anything.

STANDING

  1. I can stand up for extended periods.
  2. I cannot stand for more than one hour without pain.
  3. I cannot stand for more than 30 minutes without pain.
  4. I cannot stand at all without pain.

HEADACHES

  1. I have no headaches.
  2. I have slight headaches.
  3. I have moderate to severe headaches.
  4. I have headaches all the time.

SOCIAL LIFE

  1. My social life is normal.
  2. My social life is normal, but with slight pain.
  3. My social life is limited by pain.
  4. Pain prevents me from having a social life.

Total up your score. If your score is 3 or above, please give our office a call to set up an initial consultation. We look forward to assisting you in achieving better health through chiropractic.

 Click here Hopkins Clinic
8534 Excelsior Blvd
Hopkins, MN 55343
952-931-9867

 Click here St Paul Clinic
1201 Payne Ave
St Paul, MN 55130
651-776-8666
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