Chiropractic Forms

Written by Dr Michael Buna.

Chiropractic Treatment and Injury Assessment Tools

Headache Disabiltiy IndexDr Michael Buna may ask you to print and fill out one or more of the following forms to evaluate your injury and the impact of the injury in your life.

Each questionnaire assesses a different type of injury. The questionnaires are used by health care professionals to evaluate injuries and have been tested for reliability. Dr Buna will ask you to complete the questionnaire at regular intervals during your treatment. This information can be used to provide objective feedback on whether you are improving, getting worse or staying the same. Any information you submit in the questionnaires is confidential and will only be available to Dr Buna.

Oswestry Disability Index (for low back pain/dysfunction)

This questionnaire assess how your lower back pain may be affecting your everyday life.


Upper Extremity Functional Index (UEFI)

We use this questionnaire to determine whether you are having difficulties with your upper limb function.

Croft Disability Questionaire for shoulder function and pain

Shoulder pain and disfunction are assessed with this tool.

Headache Disability Index

This questionnaire helps to record the frequency, duration and impact of headaches in your life.

Neck Disability Index

This questionnaire assessed the impact your neck pain and its impact on your neck function.

Quadruple Visual Analogue Scale

This tool helps evaluate the impact of neck and back pain in your life.


Chiropractic Treatment Hours

09:00 - 17:30
08:00 - 17:30
08:00 - 17:30
08:00 - 18:00
08:00 - 17:30
10:00 - 01:00