Qualicum Physiotherapy Clinic

Qualicum Physiotherapy ClinicQualicum Physiotherapy ClinicQualicum Physiotherapy Clinic

Qualicum Physiotherapy Clinic

Qualicum Physiotherapy ClinicQualicum Physiotherapy ClinicQualicum Physiotherapy Clinic

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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

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