WHEELOCK CHIROPRACTIC INJURY REPORT Name Social Sec.# Home Phone
Please explain in detail how your accident happened Where did this injury occur? ____at work ____at home ____in car ___Weight trouble EYE, EAR, NOSE AND THROAT ___Eye strain ___Eye ... Visit Document
Whiplash - Indian Tree Chiropractic
The car comes out of nowhere, and then, the impact metal crushing quickly, urgency of an accident situation if you understand the types ??Eye strain ??Tremors ??Pallor ??Insomnia ??Muscle atrophy ??Rapid heartbeat . Title: ... Access Full Source
Personal Injury History Form - Dr. Randall Trester
Number of people in your car? Did your car strike the other car? Yes No Did the other car strike yours? Yes Have you missed any time from work since the accident? Yes No Eye Strain Difficulty Focusing Pain Behind Eyes Eyes Sensitive to Light Double Vision ... Fetch Full Source
Cuc Wc Injury-illness Report
Type of Accident (check all that Animal/Insect Bite Collision (car/vehicle) Foreign Body in Eye Contact with Hot Object Electrical Contact Contusion (bruise) Fall (liquid/grease spill) Strain Contact with Chemical Laceration/Puncture Other (describe below) 14. Were there any witnesses to ... Retrieve Doc
Mobile Computing Ergonomics - Havis
Squad car. Eye Strain – Eye strain is caused by poorly lit mobile computing solutions. In contrast to the well-lit offices most of us tile during an accident. Microphones – These devices should be mounted within easy reach of the officer. Once again, ... Retrieve Full Source
Personal Injury Forms
Was any one else in your car at the time of the accident? Yes No Were they injured? Yes No You were Constipation Depression Eye strain Nausea, vomiting Face flushed Palpitation Tremors Pallor Sinus trouble Mental Dullness Extreme ... Fetch Doc
News Letter The Personal Injury Clinic SPECIAL WHIPLASH EDITION
For example- a car weighing 3000 pounds traveling only 25 miles per unconscious following the accident. eye strain, tremors, pallor, insomnia (can’t sleep), muscle atrophy, or rapid heat beat. Understanding and Management ... Fetch Doc
Calorie Count :: New To This But Need A Partner And Motivation
I would like to be 168 by September but as I'm going to summer school it's going to be hard to keep an eye on the calories I I'm a 36D and any activity puts strain on my back and lungs. A car accident 3 years ago set the stage for pain galore and a bad case of pneumonia gave me the gift of ... Read Article
Robert Spadoni - YouTube
My one and only criticism is that his head is raised up which could add unnecessary strain on the neck. Laser eye beams? Superpowers? The Zach Miller of CrossFit Pittsburgh was in a car accident, and he remains comatose. ... View Video
Lifetime Eye Care
Loss of Side Vision Mucous Discharge or Crusted Lids Eye Strain with Reading or Computer Work* Dizziness or Car Sickness* Other: and/or Motor Vehicle/Bike Accident FAMILY HISTORY Check if there is a history of any of the following conditions in your immediate family? (Parents ... Read Full Source
Cornerstone Family Chiropractic
Did your car strike the other(s) involved? Shoulder Stiffness Pins and Needles in Legs Eye Strain Pain in Doing Occupation Describe the accident in detail: ... Visit Document
Location: Sutton Volunteer Bureau’s Office/ Within Local ...
Eye strain due to operating VDU. Rejection/Verbal abuse. Car accident on the way to or from authorised volunteering duties. Unforeseen Ensure that volunteer is aware of the need to take regular breaks away from the computer. ... Read Content
Accident History
Was your car moving at the time of the accident? (yes ( no . 21. If yes, how fast would you estimate you were going? _____ mph . 22. (Eye strain (Eye inflammation (Ear pain (Ear noises (Hearing loss (Nose pain (Nose discharge ... Read Here
ACCIDENT HISTORY QUESTIONAIRE
Where was your car struck? 11. Type of accident: Head-on collision Broad-side collision Front impact Rear-end in front 12. At the time of Eye, Ear, Nose, and Throat Eye strain Eye inflammation Vision problems ... Retrieve Here
Traumatic Brain Injury - Wikipedia, The Free Encyclopedia
For classifying TBI severity, grades a person's level of consciousness on a scale of 3–15 based on verbal, motor, and eye-opening reactions to stimuli. creating significant change and strain on a family who survived an accident in which a large iron rod was driven through ... Read Article
PERSONAL INJURY PATIENT HISTORY - Dr. Joe Esposito
Driver of Car: Self Other Was your car moving at the time of the accident? yes no 21. If yes, how fast would you estimate you were going? _____ mph Eye strain Eye inflammation Ear pain Ear noises Hearing loss Nose pain Nose discharge ... Document Viewer
Personal Accident Plan Follow Up Form - Albemarle County ...
Personal Accident Plan Follow Up Form benefits directly to the employee, regardless of other insurance when a covered injury occurs. Injuries may include car accidents, sports injuries, poison ivy, fractures, pulled muscles, broken teeth, burns, Eye Injuries Lacerations Fractures ... Access Document
A Drifter In Destin: High School Senior Prepares For First Pro Race Season (PHOTOS)
Alec Hohnadell keeps a few of his favorite trophies in his bedroom. He's won so many races, though, his parents have to rent a storage unit to house the rest of his awards. ... Read News
ACCIDENTAL INJURY REPORT
What kind of vehicle was involved in accident? truck car motorcycle other were you a driver passenger pedestrian? were you wearing a seat belt? yes ,no loss of memory eye strain face flushed equilibrium problems pain behind eyes face pale ... Read Full Source
Special Feature Vertical Heterophoria: New Discoveries Enable ...
Was critically injured in a car accident in which she suffered a significant traumatic brain injury. One year into her recovery, she continued to expe- Eye strain Sore eyes BiNoCulAr ViSioN SymPTomS Double or overlapping vision Shadowed vision ... View This Document
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