Dr. Deborah Ben-Shah Woodland Hills Chiropractor/Menopause Coach
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  • Home
  • Chiropractic CE Courses
  • Perfect Posture 101
  • Menopause Makeover Guide
  • Book Online Now
  • Online Menopause Coaching
  • Intake Forms
  • My YouTube Page
  • 1:1 Menopause Consult
  • Fullscript Supplements
  • Frozen Shoulder Exercises
  • Back Pain Exercises
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    • Home
    • Chiropractic CE Courses
    • Perfect Posture 101
    • Menopause Makeover Guide
    • Book Online Now
    • Online Menopause Coaching
    • Intake Forms
    • My YouTube Page
    • 1:1 Menopause Consult
    • Fullscript Supplements
    • Frozen Shoulder Exercises
    • Back Pain Exercises
    • Contact Us
Dr. Deborah Ben-Shah Woodland Hills Chiropractor/Menopause Coach

Signed in as:

filler@godaddy.com

  • Home
  • Chiropractic CE Courses
  • Perfect Posture 101
  • Menopause Makeover Guide
  • Book Online Now
  • Online Menopause Coaching
  • Intake Forms
  • My YouTube Page
  • 1:1 Menopause Consult
  • Fullscript Supplements
  • Frozen Shoulder Exercises
  • Back Pain Exercises
  • Contact Us

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Intake Forms to Download

Please click and download the top 3 forms for Chiropractic care and the bottom 4 plus the HIPPA form for Menopause Wellness Coaching (5 total forms for Menopause Coaching).

Chiropractic New Patient History Forms (pdf)

Download

Chiropractic Informed Consent (pdf)

Download

HIPPA Notice of Privacy Practices (pdf)

Download

Menopause Coaching Consent Form (pdf)

Download

Daily Food Diary (pdf)

Download

Menopause Pre-consultation assessment (pdf)

Download

Menopause Health Questionnaire (pdf)

Download

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California Chiropractic Board Licensed #DC28770 and fully insured through NCMIC

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