Wellness Wheel Form

How to Document Each Patient's Wellness

Want to see more wellness patients?

Make sure you're talking about wellness and measuring wellness.

Begin on the first visit by presenting a copy of the Wellness Wheel for each patient to complete.

"We use the Wellness Wheel to measure your overall health in seven different areas--each affecting the other. This provides a baseline so you and I can see how chiropractic care improves your overall health and well-being."

Patients rate their subjective health from 1 to 10 in seven different areas:

Physical
Financial
Family
Social
Career
Spiritual
Mental

Now you have a baseline measurement to which you can compare the impact of their chiropractic care.

You may feel a bit squeamish about the Financial spoke. After all, what does that have to do with their health and well-being?

Turns out, plenty.

it's a common source of personal and marital stress. If you're self-conscious about this aspect, when asking a patient to complete the Wellness Wheel you might say,

"You'll notice one of the spokes is labeled 'Financial.' We're not interested in your net worth or how much you make. It's just that financial health is a frequent source of stress, affecting marriages and even the quality of our sleep! So, as you evaluate your financial circumstances, see it through the stress lens."

Patients Look Forward to Their Progress Exam

After 12 visits or so schedule a progress examination. Provide another copy of the Wellness Wheel for each patient to complete.

They've long forgotten how they completed the original form.

At your progress report, compare their pre and post forms. Identify the improvements and discuss your observations.

Slow recovery? Are there underlying stresses in their life? Is one of the spokes bringing down their health?

Use the Wellness Wheel to help every patient see how chiropractic care improves not just their spine, but their life!

Wellness Wheel Assessment Handout
8½" X 11"
Pkgs. of 50

International Orders

289 Words
6.4 Grade reading level

On a scale of 1 (poor) to 10 (optimum), mark your current health level in these seven essential areas:  

Physical Health

What is your physical condition? Are you receiving good nutrition, drinking plenty of water, getting regular exercise and enjoying the proper weight for your height?

Financial Health

Are you living within your means? Is your debt within manageable limits? Do you make charitable contributions and save for the future? Are you properly insured?

Family Health

Are you in a loving relationship with shared values? Do you give your family time and attention? Do you have a close connection with children, parents and relatives?

Social Health

How well do you interact with others? Are you able to maintain long-term friendships? Are you comfortable in new social situations and the company of others?

Career Health

Do you like what you do for a living? Does your career reflect and advance your deepest values? Is your work meaningful and suited to your skills and interests?

Spiritual Health

How connected do you feel to the higher power in your life? Do you enjoy a sense of purpose and peace? Do your regularly study, meditate, pray or worship?

Mental Health

Are you open to new ideas? Do you seek out new experiences and learn new skills? What is the quality of the information and entertainment you allow into your mind?

Mental health

Are you open to new ideas? Do you to seek out new experiences and learn new skills? What is the quality of the information and entertainment you allow into your mind?


Your health affects everything you do and everyone you know. We use this confidential worksheet to record a "snapshot" of your estimated overall health so we can track your progress.

© 2003 Patient Media, Inc.