Gary Derby, D.C., M.S.
   

-Graduate, Palmer College of Chiropractic, 1981

-Master's Degree in Health Education, Truman State University, 1975

-Post-graduate training in Orthopedic Rehabilitation, Clinical Nutrition, Lower Level Laser Therapy (LLLT), and Contact Reflex Analysis (CRA)

-30 years experience in Clinical Nutrition

-Studied 5 years under Dr. John P. Dolan, author of The Care and Prevention of Athletic Injuries

-Consultant for 3 years for health and fitness to 26 school districts

   
  Paperwork
General Patient Information (for anyone 13+ yrs old)
Pediatric General Information (for anyone 0-12 yrs old)

Systems Survey Form
Are Your Health Problems Yeast Related
Consent to Treat Minor Child (for anyone under 18 yrs old)
 
  Instructions for paperwork:
 
  1. Click link to download form
  2. Complete form
    a. Fill in information on interactive forms
    b. Print and fill in information by hand
  3. Return completed form:
    a. Deliver or mail to office
    b. Fax to office (636-527-2570)
    c. Scan and email to office
    d. Click "Submit" on interactive forms to email to office
   
   
 
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