306-1110 Hamilton St.
Vancouver, BC
V6B 2S2
Phone: 604 642 6464
Stress Survey

1) Check off any of the following symptoms you have experienced in the past six months:

  Pain / Tension / Numbness:

  Digestion Trouble:

2) Does this cause you to be: 3) Does this affect your work: 4) Does this affect your life:

If you checked any of the above items, you could be suffering from:
Excessive Stress Structural Misalignment Pinched Nerves
Chiropractic can help you because Chiropractic Doctors gently treat the body, naturally, without drugs to remove the stress and imbalances that cause health problems.

There are several alternatives available to you. Please check the item most appropriate.

I would like to come in on:
- Why ask? This confirms you’re a human user