Take this 30-second to see if you qualify for a
Free
Pain & Injury Consultation.
How long have you been experiencing pain?
*
Just Recently
0-6 Months
6-12 Months
More Than 12 Months
Where are you experiencing pain?
*
Neck Pain
Back Pain
Shoulder Pain
Knee Pain
Foot Pain
Hip Pain
Other
What is this pain preventing you from doing?
*
Walking
Running
Sleeping
Exercising
Family Time
Other
What have you tried in the past to get relief?
*
Medication
Physical Therapy
Chiropractic
Physician
Googled It
Others
How old are you?
*
18-24
25-49
50-64
65 & older
What type of insurance do you have?
*
Alberta BlueCross
Medavie
ASEBP
Sunlife
Canada life
Canadian construction workers union
Chambers of Commerce group
CINUP
ClaimSecure
Cowan
D. A. Townley
Desjardins Insurance
First Canadian
Maximum Benefit
Telus AdjudiCare
Other
Other Insurance?
*
GMS Carrier 49
GMS Carrier 50
GroupHEALTH
GroupSource
Industrial Alliance
Johnson Inc
Johntson Group Inc
LiUNA Local 183
LiUNA Local 506
Manion
Manulife Financial
Greenshield
SSQ Insurance
Empire life
None of the above
No Insurance
Are you willing & able to invest in your health & wellness?
Yes
No
What's your full name?
*
What's your email?
*
What's your phone number?
*
