Forms
Physiotherapy Visits
Work Related Injuries (WCB)
Physiotherapy Intake Form
Physiotherapy Assessment Form
WCB Intake Form
Release & Request of Medical Records authorization
Motor Vehicle Injuries (Auto Insurance)
Physiotherapy Intake Form
Physiotherapy Assessment Form
AB 1 Form
Release & Request of Medical Records authorization
Private Insurance (EHB): Alberta Blue Cross, Greenshield, Great West Life etc.
Physiotherapy Intake Form
Physiotherapy Assessment Form
Direct E-CLAIM Submission Authorization Form
Release & Request of Medical Records authorization
Self-Pay Clients
Physiotherapy Intake Form
Physiotherapy Assessment Form
Release & Request of Medical Records authorization
Please complete according to the location of your injury(s)
Roland Morris Back Questionnaire
Upper Extremity Fuctional Index
Lower Extremity Fuctional Index
Neck Disability Index
Chiropractic Visits
Intake Form
Chiro Package Forms
Massage Visits: (MVA, EHB, Self-Pay)
Massage Intake Form
Release & Request of Medical Records authorization
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