Forms and Assessments - Specific Wellness

Download your forms here, print them, complete them and bring them in on your next appointment or email them to: info@specificwellness.com

Stress Assessment

Intake Form

This form is needed for all of Dr. Stacey’s new patients or if you haven’t been seen in over a year

Health Appraisal Questionnaire (HAQ)

Detox Questionnaire

GI Questionnaire

Combined Massage Therapy Intake Forms

This form is needed to be completed before your first massage appointment.

Specific Wellness Dr. Stacey Francis

6905 Telegraph Road # 119, Bloomfield Hills

5.0 60 reviews

Anca Vlasopolos ★★★★★ in the last week
Dr. Francis is extremely knowledgeable. She gets to the heart of health problems that MDs often have no answers for. I'm extremely grateful for her compassionate attention and care.
Debi Banooni ★★★★★ a week ago
Dr.Stacey’s appointment is a mix between communication, manipulation, nutrition and planning. I always walk away with homework and the results are feeling better and living better.
Elizabeth Chilton ★★★★★ a month ago
Dr. Stacey is fantastic! Excellent listener. Takes your issues seriously and is able to address them. So much better than a typical general practitioner whose recommendation for me was potential emergency surgery if my condition gets bad … More enough.
Zwenyslava Hayda ★★★★★ 2 months ago
Dr. Francis took the time to listen and address every issue that I was concerned about. I am very appreciative that I found relief by using the supplements she prescribed. Dr. Francis had recently written and released her book "THE … More SUPERCHARGED METHOD: Your Transformation from Fatigue to Energized," which addresses multiple aspects of health care. The book is written in very understandable terminology and covers a vast amount of symptoms and how to treat them. I greatly appreciate that the print is readable so one does not have to strain to read the book. It is obvious that Dr. Francis devoted much time and research to make this book beneficial in helping the lay person understand the causes and cures of ill health.
Jake Atchoo ★★★★★ 4 months ago
Dr. Stacey has completely changed my life for the better. She is a true expert in her field. I’ve seen results in my energy and overall well being in a very short period of time and have already recommended her to everyone in my network. … More She’s incredible!
Yaf Rab ★★★★★ 5 months ago
Stacy has been so helpful in so many areas with our family. We are deeply grateful for her help
Dzvinka Hayda ★★★★★ 6 months ago
Very professional and helpful with information and tecommendations pertinent to one's issues.
Vaughn Walker ★★★★★ 8 months ago
Dr. Francis is great. She's always addressing my concerns. Even when I come with many. Go into your appointments with an open mind and you won't regret it!
Tia Chavis ★★★★★ 8 months ago
Dr. Stacey took the time to discuss what I was experiencing. I felt supported and cared for. I'm so thankful to have her guide me on my journey to wellness.
Cassie Sobelton ★★★★★ 10 months ago
Dr. Stacey Francis is a fantastic chiropractor & so pleasant to be around. I highly recommend her.
Hind Patros ★★★★★ 11 months ago
I went in for an adjustment, due to waking up with a severe headache this morning, and just like that, my headache was gone! Thank you Dr. Stacey!!
Maureen Sullivan ★★★★★ 11 months ago
Was awarded a last minute appointment when I sorely needed it and left ready to make a 4 hour drive. Thanks and Go Dr Stacey and thanks for your help and support. Sincerely, Maureen
Michael Saunders ★★★★★ a year ago
23 years ago I hurt my back playing basketball, a friend recommended I see Dr. Francis. That visit was and continues to be a life changing decision. She not only corrected my back problem but also fixed other annoying pains. Even though … More I relocated to other cities, I still made my way back to Michigan to see Dr. Francis. No matter the problem, she always has a gentle healing solution. My wife and I have recommended her to many family and friends because she's truly AMAZING!
Carolina Velazquez ★★★★★ a year ago
Dr. Francis is absolutely amazing!!! I came to her with, what I thought were so many issues and she was able to help me with them all! She took her time to hear me out during out initial consultation and I am beyond happy with my results! … More I was dealing with pre-menopausal symtoms such as weight gain and night sweats and she immediately put me on an eating plan and supplement plan that not only helped me lose 11 pounds, but reduced the night sweats within a month. She is so much more than just a chiropractor, she really wants to help get to the bottom of whatever is bothering you by examining you as a whole. She is one of the most amazing people and she just makes me smile when I see her. Go see Dr. FRANCIS RIGHT NOW!!! You won't regret it!
Molly F ★★★★★ a year ago
Before seeing Dr. Francis, I had stomach aches every day, painful eczema, headaches, and terrible allergies. After one visit, she figured out I had an inflammation issue in my GI system. She created a plan for me and after a few diet changes, … More I already felt so much better. My stomach aches went away almost immediately, and it will take longer for my eczema to clear up, but it has already been a lot better. I had seen some doctors before for all my issues and I never got a good solution. I also never thought they were all related. I am so grateful for Dr. Francis and how she has turned my health around for me!
Greg Gelow ★★★★★ a year ago
I tried Dr. Francis on a recommendation from a friend. I had been using another Doctor with limited results and needed a new approach. Dr Francis took the time to review my condition, perform an adjustment and make specific recommendations … More to help me get better faster. Its been only one day and I feel better already with a lot less pain and have been following the Doctors orders. I go back in a couple of days for more evaluation and adjustments. I would recommend Dr. Francis just because one visit and I feel better, wish I was here two weeks ago getting help.
Menucha Polter ★★★★★ a year ago
I was suffering from insomnia, and exhaustion. My knees hurt which I tried physical therapy for and did not work. With a change in my diet and supplements, my sleep and energy levels are amazing. And with a few adjustments my knee pain … More is gone! Dr. Stacey Francis deals with the issue, the real one. I’m so grateful 🙏🏼
Greg Ervin ★★★★★ a year ago
Have known Dr. Francis for over 15 yrs. She is well trained and educated. I would refer anyone to her needing a adjustment and holistic care. She will find a way to help you.
Carol Perkins ★★★★★ 4 years ago
I cannot say enough about Dr. Stacey. She is very passionate about what she does. I have been seeing her for a couple of years now for both chiropractic as well as nutritional advising. I have had issues most of my life that doctors … More were never able to figure out. She has guided me on a diet change that has so far done more for me than any doctor in any specialty field has done. When other doctors gave up, Dr Stacey was just getting started. She cares so much about her patients and their health. She has gone out of her way to make sure I get the medical attention that I need. She is very educated in her field of work and I trust her fully. She has truly changed my life. Thank you Dr Stacey !