New Client Information

Submit this form to be contacted by our front desk staff to get in and see one of our therapists

MM/DD/YYYY
Describe your symptoms. If you have seen a doctor or practitioner try to use their verbiage as well as including your own description.
or length of time experiencing symptoms
if you are in a movement limiting device already, please describe it
Please select the types of imaging you have had for this case.
Where did you have your imaging done? (IE TBRHSC, Thunder Bay Diagnostic, etc)
Note; we are a private clinic and do not do direct billing except for WSIB and MVA cases. All appointments are paid for by the patient and receipts can submitted for reimbursement to your extended healthcare provider. NOTE: If we book you for a type of therapy you say you have coverage for here but do not, you will be paying out of pocket. Please double check your coverage.
WSIB Cases only
WSIB Cases only
WSIB Cases only
WSIB Cases only