#1 - 140 First Avenue West, Qualicum Beach, British Columbia V9K 2R5, Canada

Appointments: {250-752-3212}

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Appointments: {250-752-3212}

Home
Covid-19 Response
Forms
Staff
Our Partners

Qualicum Physiotherapy Clinic

Qualicum Physiotherapy ClinicQualicum Physiotherapy ClinicQualicum Physiotherapy Clinic

Regular Patients

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

New Patient Form (pdf)Download

Privacy Policy (please review) (pdf)Download

IMS / Dry Needling

IMS / Acupuncture Information and Consent (pdf)Download

ICBC / WorkSafe BC 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

Telehealth

Telehealth Info and Consent Form (pdf)Download

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