Dr. Deborah Ben-Shah Woodland Hills Chiropractor/Menopause Coach

818-457-1746

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

818-457-1746

Dr. Deborah Ben-Shah Woodland Hills Chiropractor/Menopause Coach

Signed in as:

filler@godaddy.com

  • Home
  • Chiropractic CE Courses
  • Book Online Now
  • Menopause Makeover Guide
  • 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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  • My Account

  • Sign out

  • Sign In
  • My Account

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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FREE Posture Correction Live Webinar 07/13/25 @ 11 am PST

Join Chiropractor Dr. Deborah Ben-Shah for a live and interactive online Posture Correction workshop. Learn how to:

  • realign your posture 
  • restore your health
  • regain mobility
  • relieve tension
  • reduce pain

Book your spot today!