Testimonial Testimonial Submission Form Others would love to hear your chiropractic story. Please use this form to jot down your journey. If you would like to remain anonymous, simply leave the "name" and “email” fields blank. Name First Name Last Name Email This is a testimonial about: * Quality of life Comfort levels Better looking posture Enhanced performance (Work, home, athletics, etc.) Overall health Prevention Wellness Other Life Before Chiropractic * In this section, please tell us how your life was limited, how your activities of daily life were affected, or how you were feeling before you started chiropractic care. What was your life like then? Life After Chiropractic * In this section, please tell us how your life has changed, what you are able to do now or about how you are feeling since you started chiropractic care. What is your life like now? Additional comments Permissions * I grant the Chiropractic Health Institute permission to share my testimonial to help others. This may include posting my name and testimonial on the office's website and/or in newsletters, emails, or other marketing materials. Yes No Thank you.
