Voted The Diamond Award Best Physiotherapy Clinic and Massage Therapy Clinic by Economist & Sun

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647-799-0966

254 Main Street North, Markham, Ontario L3P1Y7

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Instructions: Please Watch the Video Then Fill Out This 30 Second Form to Tell Us EXACTLY How You Want Us To Help YOU… The More We Know About You, the Better We Can Help You…

Step 1 About you
Step 2 Your Pain/Injury
Step 3 Finish!

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Primary Reason for Wanting to Speak With a Specialist *

I'm in lots of pain and want some tips and advice I can start using right away
I would love to know what's wrong and how long it will take to ease
I'm not sure if physiotherapy is right for me and talking to a specialist first would help me decide
I want to know more about your equipment (e.g. Anti-gravity treadmill)

Where Does It Hurt? *

What Does It STOP You From Doing? *

What Concerns You Most? *

How Long Have You Suffered or Worried? *

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254 Main Street North, Markham, Ontario L3P1Y7
647-799-0966
nick@physioforsurgery.ca

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