holistic care & treatments

health screening

DO YOU Have?

  • Lack of Energy
  • Herniated or Bulging Discs
  • Sciatica
  • Spinal Stenosis
  • Degenerative Disc Disease
  • Chronic Back Pain
  • Facet Syndromes
  • Post Surgical Back Pain
  • Pinched Nerves
  • Total Exhaustion
  • Overweight, Bloating, Obesity
  • High Blood Pressure
  • Out-of-Control Blood Sugar Levels
  • High Cholesterol Levels
  • Damaged or Poor Immune System
  • Chronic Inflammation
  • Joint and Muscle Aches and Pains
  • Sporadic or Chronic Pain
  • Poor Circulation
  • Escalating Health Problems
  • A Desire for Improved Health
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WellnessFirst™ Intake Questionnaire

When you make an appointment for your Initial WellnessFirst™ Assessment you will be asked to fill out a comprehensive health questionnaire.

Feel free to drop by the office for a copy, or download one of the following copies. We have the form available for you in a PDF format, which you can print out. We also have a Microsoft Word doc version. You can download the doc into your Word program, fill it out and email it back to us.

Please leave yourself plenty of time to fill the form out fully and return it to us before your initial assessment appointment.

WellnessFirst™ Intake Questionnaire PDF

WellnessFirst™ Intake Questionnaire Microsoft DOC

If you have any questions, contact us at 604-517-8500


Health Screening
Blood Quality Analysis
Contact Regulation Thermograph
Biopulsar Energy Mapping
WellnessFirst™ Intake Questionnaire
Metabolic Typing
Polar Tri-Fit BodyAge™