Your Membership Orientation BACK
Your results depend upon how you would like to live.
How do you want to define your challenges?
Print this page for your consultation meeting. Be sure the entire document prints.
Name___________________________________________________________________
Address________________________________________________________________
Phone day/night_________________________________________________________
Date of Birth___________________________________________________________
email address____________________________________________ [ ] subscribe to email
newsletter
1. Health is built through natural means and broken down by unnatural means.
a. What are some current unnatural events or stresses causing negative consequences in
your life_______________________________
b. What natural things are doing right now to help put balance into your
life_________________
2. In the most profound way, the spinal adjustment naturally enhances your body’s survival system: the
brain and spinal cord.
You have what it takes to make your life great.
Many people don’t realize it or acknowledge it.
Many spend a lifetime missing out on it.
Advanced chiropractic concentrates on increasing confidence in how the body and mind work.
The philosophy, art, and science of chiropractic are some of the greatest tools to guide you though a life of
health and vitality.
Welcome to Homic Advanced Chiropractic
Chiropractic is a drug-free, surgery free approach to health.
Chiropractic is focused on releasing stored spinal subluxations that shut down the body’s survival
mechanism.
Advanced chiropractic is a mind-set centered on the synchronization of the mind and body for a full life
experience.
Personally developing your human potential is the foundational philosophy of chiropractic care and the
chiropractic lifestyle.
Homic Advanced Chiropractic presents the blending of mind and body function by:
1. Using the adjustment to enhance the brain-body connection.
2. Incorporating a personal development curriculum that reinforces mind and body balance.
“The way you take care of your health is the same way you take care of everything else.”
Do you see the connection? [ ] Y [ ] N
Are you ready to learn more? [ ] Y [ ] N
Two stages of advanced chiropractic:
Stage I. Learn to live
Stage II. Live to learn
Live by default or live by thought?
Why do people seek chiropractic care?
a. pain has signaled an imbalance in their lives. (The body heals under the right conditions.
Chiropractic treats the imbalance not the pain.)
What imbalances are you dealing with right now___________________________________________
b. they want to perform better to reach their goals. What goals are you working on or would
like to work
on_____________________________________________________________________________
Reframe it the advanced chiropractic way:
1. Restore balance to live your best life
2. The body speaks when the mind is in denial.
3. Stop medical label abuse: reclaim the human being; we live in a society that “discriminates
by diagnosis.” [psycho-social impact]
Check which of the above do you wish to explore? 1___ 2___ 3___
Advanced Chiropractic
Advanced Thinking…………..Advanced Living
Stage I. Learn to live
Subluxations are like graffiti on the spine: ugly markers of a silent but destructive process turning off the
brain and body’s vital connections.
How well you healed in the past is driving your vitality today.
How well you heal today drives your future healing.
Past Health History:
Physical trauma leads to physical imbalance
a. birth trauma (your birth)/illness/complications at
birth___________________________________
b. childhood illness / hospitalization_________________
c. adult illness / hospitalization_____________________
d. fractures, surgeries, falls_________________________
e. work accidents_____________________________
f. motor vehicle accidents (even if minor)_____________
g. sports / recreation accidents______________________
h. repetitive activities at work, home etc.______________
i. exercise or lack of exercise______________________
j. pregnancies____________________________________
Chemical trauma leads to chemical imbalance
k. describe your diet_______________________________
l. how much raw fruit/veggies in your diet_____________
m. water consumption______________________________
n. artificial sugar use______________________________
o. caffeine/coffee/soda____________________________
p. cigarette smoking______________________________
q. alcohol consumption___________________________
r. supplements__________________________________
s. prescription drugs______________________________
t. over the counter drugs__________________________
Emotional trauma leads to emotional imbalance
Events happen. How will we respond?
u. life change stress in last 5 years, marriage, divorce, relocation, job loss/promotion,
birth, death______________________________
v. work satisfaction_______________________________________
w. relationship satisfaction_________________________________
x. self talk, what are you denying yourself____________________
y. addictions, emotional addictions_________________________
Stage II. Live to learn
The adjustment is vital to life. It will only be fully realized with the continuous mind-set of nurturing life.
Free the mind to free the body.
Free the body to free the mind.
You must to both.
Chiropractic care is a life-long process of self growth and enhancing human potential. During stage II you
have the opportunity to explore how you do more than feel better but do more to make you and your
community better.
How?
Stage I. Learn to live
Restore balance. Evaluate habits and behaviors that give the adjustment lasting impact.
Stage II. Live to learn
Consistently fine tune & seek growth. The adjustment fine tunes the body-mind. Fine tuning behaviors
and habits to impact the life experience.
Follow these steps for each stage: (1) get adjusted weekly (2) design and live your life (3) read suggested
books on CreatePurpose.com (4) keep a journal
“Chiropractive 24/7”
Be More Alive
You can think about these questions now. We will address them as you continue on your
wellness journey.
I look forward to seeing you at our first meeting.
1. My weekly adjustment:
What positives do I bring to the table?
What stresses do I bring to the table?
2. Design & Live A Balanced Life
How is my body telling me I am living with more balance?
What are my thoughts focused on lately? Do they enhance my balance?
3. Self Growth……………
Learn to Live/Live to Learn
What am I learning this week?
What am I reading this week?
4. Keep a Journal
How am I connected to the rest of the world?
How many of my actions are congruent with my calling?
How can I be more organized?