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Physiotherapy – Initial Consultation

  • Your Presenting Problem

  • Please indicate on a score of 0 to 10, how intense the pain is. (0=no pain, 10=extreme pain)

  • General Health

  • Lifestyle and Wellness

  • If you could improve anything about your health, what would be your goals?
  • Treatments

  • The practitioners at North Sydney Sports and Chiropractic may use any of the following therapies in your care:

    • Spinal Manipulative/Adjustments
    • Soft Tissue Mobilization
    • Exercise Rehabilitation
    • Nutritional therapy/advice
    • Taping Techniques
    • Dry Needling Techniques
  • The therapies offered by the practitioners at North Sydney Sports and Chiropractic have a long history of practice; however as with all treatments there are some inherent risks. These include:

    • Aggravation of an existing condition
    • Headache
    • Rupture to disc
    • Sprain/Strain to disc or ligament
    • Infection
    • Stroke or stroke-like symptoms
    • Relaxed or sleepy feeling
    • Bruising or muscle soreness
    • Sprain/strain to muscle or tendon
    • Fracture
  • Please tell your practitioner if you do not want a particular type of treatment.

    • I understand the possible risks of the treatment outlined above.
    • I give consent to the proposed care by any practitioner who operates at North Sydney Sports and Chiropractic.
    • This consent does not waiver your Common Law Rights; rather it is merely for you to acknowledge that you have been informed of the common known risk.
    • I understand that I can withdraw my consent to treatment at any time
    • I give consent to my patient notes to be shared with practitioners/therapists that work within North Sydney Sports and Chiropractic and will not be used for any other purposes than the treatment of my condition and health.