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<\/p>\n<\/p>\n
(Directions: Please write a few sentences regarding your condition before treatment, and then a few sentences regarding your condition now after receiving the health care we provided.)
\nName ________________________<\/p>\n
1.\u00a0Describe your condition. How long had you been suffering?\u00a0 How did it start?
\n2.\u00a0What previous unsuccessful steps had you taken to try to solve your problem?<\/p>\n
3.\u00a0How did you find out about Dr. _____________?<\/p>\n
4.\u00a0Describe what Dr. _______________\u00a0 did to help you. ( Examination, x-ray, treatment program, etc.)<\/p>\n
5.\u00a0What did Dr. _______ tell you your problem was?<\/p>\n
6.\u00a0Describe your progress, your results , and the benefits you received.
\n7.\u00a0How has your life been improved since coming to our office? What can you do now that you could not do before?
\n8.\u00a0Words of encouragement for others who have similar problems.
\nSignature _____________________________ Date_________
\nI hereby give my permission to publish my success story in whole or in part: (initial) _______<\/p>\n
<\/p>\n <\/span><\/p>\n When the patient is ready to write their \u201csuccess story\u201d, have her or him fill out this survey.<\/p>\n Then, you can re-type it and have them sign the new version. Type the following on the bottom of the newly retyped story. When you display the patient’s story, you can mention: “(Individual results vary. These accounts were obtained without remuneration and within HIPAA guidelines.)”\u00a0 You may also want to check with your state association if you have any questions.<\/p>\n I hereby give my permission to publish my success story in whole or in part: These are my health care successes: (Directions: Please write a few sentences regarding your condition before treatment, and then a few sentences regarding your condition now after receiving the health care we provided.) Name ________________________ 1.\u00a0Describe your condition. How long … Continue reading
\nProcedure for
\nSuccess Story
\nQuestionnaire Form<\/span><\/span><\/h2>\n
\n<\/span><\/span><\/p>\n
\nSignature _________________________________\u00a0\u00a0 Date:______________________<\/p>\n","protected":false},"excerpt":{"rendered":"