Patient Name: - ChiroUp
A. HEAD PAIN, HEADACHES, FACIAL D. TEETH AND GUM PROBLEMS H. THROAT PROBLEMS PAIN Clenching, Grinding at Night Swallowing Difficulties Forehead L R Looseness and/or Soreness of Back Tightness of Throat Temples L R Teeth Sore Throat Migraine Type Headaches Tooth Pain Voice Fluctuations Cluster Headaches Laryngitis Maxillary Sinus Headaches ... ................
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