2010 Wilshire Blvd. # 506
Los Angeles, CA 90057



Take the Stress Test

The purpose of this stress survey is to determine if any health problems you may be having are due to stress. * indicates required information.

    By completing this survey, you qualify to receive a new patient information packet.
    1) Check off any of the following symptoms you have experienced in the past 6 months:
    Headache/TensionFatigue/TiredPain Anywhere in BodyDigestive DisturbanceDifficulty SleepingIrritabilityLow Back PainNeck PainWrist/Hand PainElbow PainShoulder PainHip PainPain Between ShouldersKnee PainAnkle/Foot PainRinging in EarsNervousnessDizzinessAllergiesTension Across Top of ShouldersNumbness/Tingling in Arms or HandsNumbness/Tingling in Legs or FeetWeight Trouble

    If you checked any of the above items, then you could be suffering from:
    Excessive Stress ·
    · Structural Misalignment ·
    · Pinched Nerves ·

    We Can Help You because we gently treat your body, naturally, without drugs to remove the stress and imbalances that Cause health problems.

    If your answer is Yes, there are alternatives available to you. Please check the item most appropriate for you.

    I would like to come to Dr. Rodney Barnajian for a complete evaluation. Please call me to schedule an appointment.I would like Dr. Rodney Barnajian to me to discuss my health problems before making an appointment.I am interested in receiving more information from Dr. Rodney Barnajian