Qualicum Physiotherapy Clinic

Qualicum Physiotherapy ClinicQualicum Physiotherapy ClinicQualicum Physiotherapy Clinic

Qualicum Physiotherapy Clinic

Qualicum Physiotherapy ClinicQualicum Physiotherapy ClinicQualicum Physiotherapy Clinic
  • Home
  • Forms
  • Island Health PT Voucher
  • Services
  • Staff
  • News/Events
  • Our Partners
  • Job Opportunities
  • Public Health
  • Store
  • More
    • Home
    • Forms
    • Island Health PT Voucher
    • Services
    • Staff
    • News/Events
    • Our Partners
    • Job Opportunities
    • Public Health
    • Store
  • Sign In
  • Create Account

  • My Account
  • Signed in as:

  • filler@godaddy.com


  • My Account
  • Sign out

Signed in as:

filler@godaddy.com

  • Home
  • Forms
  • Island Health PT Voucher
  • Services
  • Staff
  • News/Events
  • Our Partners
  • Job Opportunities
  • Public Health
  • Store

Account


  • My Account
  • Sign out


  • Sign In
  • My Account

Regular Patients

For most patients, these forms are all you need to get started

New Patient Form (pdf)Download
Extended Health Consent Forms (pdf)Download
Privacy Policy (please review) (pdf)Download
Benefit Assignment Form (pdf)Download
Sun Life Consent and Authorization for Electronic Claims (pdf)Download

IMS / Dry Needling

IMS Info/Consent Form (doc)Download

ICBC - Outcome Measures

Lower Extremity Functional Scale (pdf)Download
Neck Disability Index (pdf)Download
Arm, Shoulder and Hand (pdf)Download
Low Back Oswestry Scale (pdf)Download

WorksafeBC forms

WSBC - Initial Appointment (doc)Download
WSBC - JOB DEMANDS QUESTIONNAIRE (pdf)Download
WSBC - Claim Status and Appointment Cancellation Policy (doc)Download

Telehealth

Telehealth Info and Consent Form (pdf)Download

Copyright © 2025 Qualicum Physiotherapy Clinic - All Rights Reserved.

  • Forms
  • News/Events

Powered by GoDaddy Website Builder