Take this 30-second quiz to see if you qualify for a
$21
Pain Relief Session.
How long have you been experiencing pain?
*
Just Recently
0-6 Months
6-12 Months
More Than 12 Months
Where are you experiencing pain?
*
Neck Pain
Back Pain
Shoulder Pain
Knee Pain
Foot Pain
Hip Pain
Other
What is this pain preventing you from doing?
*
Walking
Running
Sleeping
Exercising
Family Time
Other
What have you tried in the past to get relief?
*
Medication
Physical Therapy
Chiropractic
Physician
Googled It
Others
How old are you?
*
18-24
25-49
50-64
65 & older
What type of insurance do you have?
*
SUN LIFE
MANULIFE
CANADA LIFE
GREAT WEST LIFE
INDUSTRIAL ALLIANCE
BLUE CROSS
GREEN SHIELD CANADA
CLAIM SECURE
EQUITABLE LIFE
SSQ
EMPIRE LIFE
NEXGEN Rx
THE CO-OPERATORS
MEDIC CONSTRUCTION (GREEN SHIELD CANADA)
CANADIAN ARMED FORCES
ROYAL CANADIAN MOUNTED POLICE
VETERANS AFFAIRS CANADA
COWAN INSURANCE GROUP
Other
Other Insurance?
*
JOHNSON GROUP
JOHNSTON GROUP
CHAMBERS OF COMMERCE
MAXIMUM BENEFIT
FIRST CANADIAN
GMS CARRIERS 49 AND 50
CANADIAN CONSTRUCTION WORKERS
CINUP
DESJARDINS
GROUP HEALTH
GROUP SOURCE
LIUNA LOCAL
MANION
RWAM INSURANCE
TELUS ADJUDICARE
UNION BENEFITS
None of the above
No Insurance
Are you willing & able to invest in your health & wellness?
*
Yes
No
Our staff has reserved their time for people who are serious about improving their health and wellness. Will you be able to commit to this appointment after confirming the day and time with our front desk?
*
Yes
No
What's your full name?
*
What's your email?
*
What's your phone number?
*
