ASRF Case Report Project Submission

Welcome, and thank you for considering submitting your case to the ASRF Case Report Project.

IMPORTANT: Please carefully read all the ASRF Case Report Guide 2023, as well as the notes below, before submitting your case study:

All submissions must be received by 18th July, 2023. No exceptions will be made for late submissions.
Be sure to fill in all fields in as much detail as possible – this will give you the best chance of having your submission accepted, given that we have a limited number of cases that will be able to be written up and published as case reports.
Please only submit cases that align with the topics we have put forward: Immunity, Stress and Adaptability.
Your submission will be reviewed by the ASRF Clinical Advisory Panel and Research Committee and we will contact you in early August 2023, to let you know if your submission has been accepted or not.
If accepted, you will be contacted by our team, so that you can provide us with your patient notes and consent forms. While all security precautions have been taken with this form, please DO NOT include any identifying patient information in the form below.
Please note that due to our anticipation of a high number of submissions, preference will be given to ASRF Members, if we receive more submissions than we can fund. Not a Member? Join here.
If you have any questions, please feel free to contact Bridget at bridget@spinalresearch.com.au.

Note: You can save your progress and return to the form at a later date, if needed. Go to the bottom of the form.

Chiropractor's Name (ie: name of the chiropractor whose case is being submitted)*
First Last
Associate Chiropractor (if applicable)
First Last
Contact Person's Name*
First Last
Contact Person's Email*
Patient Details
Age*
Gender*
Profession
Activity Level
History with chiropractic care*
- New to chiropractic care
- Limited experience with chiropractic care
- Irregular chiropractic care
- Under regular chiropractic care
Relevant Medical History*
Main complaints/daily life dysfunctions*
Secondary complaints/daily life dysfunctions
If a paediatric case, please provide relevant birth history and maternal health during gestation.
Examinations. IMPORTANT: Please include findings from exam #1 and for relevant follow up exam/s.
Clinical findings.*
Which measures were used?*
Subluxation findings*
Management
Chiropractic techniques or protocols used*
Method/s of adjustment*
Additional care recommendations, if any
Care plan/schedule*
Aims of care*
Timing and outcomes of reviews*
Specific areas of focus*
Outcomes
What changed? What did you observe? Include subjective and objective.*
How did you measure the changes?*
What did the patient say about the changes?*
Discussion
What do the changes mean for the patient (both clinically and in terms of their daily life)?
How do you think this was achieved? Did your care likely contribute to their improvement?
What do you think this case mean for future individuals under chiropractic care?
Are there any gaps or limitations?
What would you like to see for future research?
Do you have any additional thoughts?

Save and Continue Later

ASRF Case Report Project Submission

Patient Details

Examinations. IMPORTANT: Please include findings from exam #1 and for relevant follow up exam/s.

Management

Outcomes

Discussion