The Back Clinic Consultation

So we know how to address you, what’s your first name?(Required)

Where are you feeling pain right now?(Required)

Select the area that bothers you most. This helps us personalise your treatment plan.

Lower back pain

Sciatica or nerve pain

Neck or shoulder pain

Joint or mobility issues

Headaches or migraines

Something else

How long has this pain been bothering you?(Required)

This helps us understand whether it’s a recent injury or something chronic, so we can tailor our care.

Less than 1 week

1–4 weeks

1-3 months

Over 3 months

My pain comes and goes

How much is this pain affecting your daily life?(Required)

No judgment. This helps us prioritise those in most discomfort first.

Mild (It’s annoying, but I can manage)

Moderate (It’s affecting my sleep, mood, or movement)

Severe (It’s getting worse and I need help now)

Not sure (it varies day to day)

What have you already tried to feel better?(Required)

We ask this to avoid repeating treatments that haven’t worked, and to tailor our care better.

Nothing yet — I’m just starting to look

Over-the-counter pain medication

Saw a GP

Saw a chiropractor

Exercise/stretching

Massage or acupuncture

Have you seen a chiropractor before or would this be your first time?(Required)

It's completely fine if you're new to this. We'll walk you through everything clearly.

Yes, within the last 6 months

Yes, but over 6 months ago

No, this would be my first visit

I’m not sure, I can’t remember

How soon would you like to get help with this?(Required)

The sooner we know, the sooner we can help you feel better.

As soon as possible

Within the next two weeks

In the next few days

I'm just researching for now

What are you hoping to get out of chiropractic care?(Required)

This helps us recommend the type of care that suits your goals and lifestyle.

I just want quick relief from pain

I’m open to ongoing care if it works for me

I’m not sure yet, happy to get some guidance

Do you have any health cover that could help with treatment costs?(Required)

We ask this to make sure you get the right info on rebates and billing.

Yes, I have private health

Yes, I have Medicare

I have both

No, I don’t have any cover

I’m not sure

What time of day suits you best for a callback?(Required)

We’ll do our best to contact you during your preferred time window.

Morning (8am to 12pm)

Midday (12pm to 3pm)

Evening (3pm to 6pm)

Anytime (I don't mind)

Which clinic do you prefer to visit?(Required)

Rockdale

Bankstown