Please download and fill out these forms prior to office visit
Please note that this page is expressly for patients of Charles L. Blum, DC and is not to be used by the general public. If you are not a patient of Dr. Blum you do not have authority to view or use the information on this page.
The forms on this page are used to assist Dr. Blum in gaining pertinent history information as well as to assist in better interpreting your clinical presentation. If you have any questions please e-mail Dr. Blum at firstname.lastname@example.org or call the office at 310-392-9795.
SPECIFIC CONDITION FORMS
Please download and fill out the appropriate forms related to your specific condition.
GREATER THAN 4-8 WEEKS
LESS THAN 4 WEEKS