Please check off any symptoms that apply to you to assess your spinal health:
| PAIN | LOSS OF FUNCTION |
| □ Neck Pain/Stiffness | □ Frequent Colds/Flu |
| □ Headaches/Migraine | □ Asthma |
| □ Pain between Shoulders | □ Sinus/Allergies |
| □ Pain/Numbness in Arms or Hands | □ Fatigue |
| □ Pain/Numbness in Legs or Feet | □ Ear Infection/Tonsillitis |
| □ Low Back Pain | □ Dizzy/Light-Headed |
| □ Car Accident | □ Difficulty Sleeping |
| □ Serious Fall or Injury | □ Nervousness/Depression |
| □ Arthritis or Swollen Joints | □ Poor Concentration/Memory |
| □ Spinal Curvature (Scoliosis) | □ Muscle Weakness |
| □ Walking Problems | □ Digestive Problems |
| □ Sports Injuries | □ ADD/ADHD |
If you’ve checked off any of these symptoms, there is a possibility that you have spinal subluxations (misalignments). If left unchecked these health issues can worsen over time and cause permanent damage.
Subluxations can be caused by:
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Regular visits to your chiropractor can help reduce the effects of subluxations and restore health back into your body. To check if your health problems are caused by subluxations, give us a call at 519-653-1020.
If you print off this survey with your results and bring it with you to your First Appt, you will receive your Initial Visit with us (Consultation, Physical Examination and X-rays – if necessary) for only $39.00 (Normal Fee $170.00)! This is valid only until August 28, 2014.

Not everyone has to be an olympic caliber athlete to benefit from chiropractic. Any athlete who wants to enhance personal performance can benefit. You may run 2km for the first time in your life, or you may complete your 20th marathon. No matter what your level, chiropractic can give your athletic endeavours an edge. I’m reminded of my mother-in-law Gloria when she completed her first 5K run at the Toronto ScotiaBank Waterfront Marathon. It was her way of celebrating her 70th birthday by facing a challenge and achieving a goal that claimed age is just a number. It took courage, discipline and regular chiropractic care that brought her into 6th place out of the 49 in her age category (3rd out of all the women)! Her first run! I can’t tell you how proud I was of her, and what an inspiration she is!
Thought I’d start with the very basics of keeping your spine happy and healthy. Keep in mind, how you treat your spine today will affect your quality of life in the future!
