Forms2017-07-25T23:04:10+00:00

Forms

Take your time in a comfortable setting while completing your intake health questionnaire forms prior to arriving at the office.

We offer our initial introduction forms online so you can print out and complete them in the convenience of your own home and have them already filled in at your appointment time. If you choose to not fill these out ahead of time, then please arrive 15 to 20 minutes ahead of your appointment time (excluding a 9 am appointment) to be able to complete them as your appointment time is the scheduled time that the doctor will see you. The Health Intake form and the Arbitration form are required for all patients and need to be completed prior to being seen as a patient in this office. Also please bring  along  a driver’s license or other government picture ID for us to copy.

Every patient must complete this form as it will provide us a basis for which to assess your condition. It is a standardized form used in most health care offices. Please remember to sign and date it.

Download and print form

This is a form that is required to be signed in order to be a patient in this office. Our insurance requires that all patients read and sign this form prior to any care being rendered.

Download and print form

If your health issue is the result of a car accident or slip and fall in your home we need some additional information. This form will give us a good start in obtaining the facts of what happened (only if you have been in an accident within the last 12 months or your end relates to a specific incident or injury).

Download and print form

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..he genuinely and sincerely cares about his patients

I have known Dr. Hawn for over 2 years.  Unlike numerous success stories you’ll read, I am not a patient.  I’ve collaborated with Dr. Hawn over the last two years developing his digital presence to tell others about his services.  I have learned a great deal about Dr. Hawn’s character, his proficiency in the field of Chiropractic Care, and most importantly his genuine interest in the wellbeing of those he serves.

Throughout Dr. Hawn’s website a visitor learns of Dr. Hawn’s depth of knowledge in the field Chiropractic Care along with his formal education at the prestigious Palmer College of Chiropractic.  Credentials and knowledge are factors in considering a health care professional, and many visitors to his website, just like you choose Dr. Hawn because he genuinely and sincerely cares about his patients.  Dr. Hawn’s patients include the young, old, women, men, and even individuals that seek his expertise on preventative care.

Dr. Hawn is my client, he’s also a friend, and If you were led to this testimonial seeking assurance that the decision you’ll make today to call him is good decision, then you are absolutely correct.  Call Dr. Hawn, he will help you improve the quality of your life through professional Chiropractic Care!  Finally, in so far as I’m aware, Dr. Hawn is the only mobile chiropractor in Orange County. . he comes to you to help you!  Call him now at 949-388-0800.

-Dan R.

 

Only one treatment and I felt immediate relief

“Hi, I’m Terry Hawn, Dr. Hawn’s wife. You’ve heard the old saying that the shoemaker’s children have no shoes. Well what that means is usually the shoemaker is so busy making shoes for other people that he’s too busy to make shoes for his own family. Not so with my husband, and I’m not just going to sing his praises because he’s my husband. I’m the first to say if something isn’t right. But I will tell you that my husband really saved my life with a treatment called Vibration Wave on what was diagnosed as Morton’s Neuroma. It was a major pain under my left foot.

It was so painful; this bundling of nerves that surgery, according to most podiatrists, was the only offered solution. Dr Hawn acquired this fabulous piece of equipment that breaks up scar tissue and adhesions and has evolved its application into what is now called Vibration Wave Therapy. While testing, he applied only one treatment and I felt immediate relief. So I’m not just blowing smoke, I’m telling you that this vibration wave treatment really works. So, I’m hoping maybe you too will give it a try.”

Terry Rifkin-Hawn

I can only say I was ecstatic to feel relief in my low back

“After suffering for more than four years with neck and low back pain from an auto accident, I noticed I was beginning to feel a loss of sensation around the front of my right thigh. I went to my doctor who gave me three spinal injections which worked temporarily but did not last.

After two more months of constant and extreme pain I went back to my doctor.  He sent me to physical therapy for three months and it provided no relief.  In fact, I think it made it worse. All they did was heat me up and use electric stimulation and stretching.

I feared I was going to have a permanent disability and lose all the feeling in my right leg.  My neurologist told me that I would probably need surgery but suggested that I try to hold out until I couldn’t stand the pain any more.

My friend recommended Dr. Chris.  I went to see Dr. Chris and he discussed my problem with me. The way he explained it, it all made sense. The nerve flow originating out of my low back was radiating down my leg. Find which nerve is being blocked and relieve it.

I can only say I was ecstatic to feel relief in my low back after only a few treatments.  Within six weeks I had all the feeling back in my leg and no low back pain whatsoever.  This has definitely put on hold any need for surgery in the near future.”

Robert Fowler
U.S. Army Retired
Viet Nam Veteran

Life is Too Short to Live in Pain!