Patient Forms

Please download or print off the required forms (.pdf format) below using the icons which appear when you hover at the bottom of each form. Complete the form and scan for eamiling to us or bring to the office at time of your appointment.

  1. Patient Information Form
  2. General Health Questionnaire

PATIENT INFORMATION FORM

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GENERAL HEALTH QUESTIONNAIRE

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Clinic Information

GELLEY CHIROPRACTIC
12-845 Dakota St.
Winnipeg, Manitoba R2M 5M3
(Across from St. Vital Shopping Center)

HOURS
Monday to Friday 8:30 AM to 6:00 PM
Saturday 10:00 AM to 2:00 PM

APPOINTMENTS
CALL: 204.254.0130 Winnipeg

Daily Online Exercise

Disclaimer

All information is for general information only and should not be treated as a substitute for medical advice from your own Doctor of Chiropractic, Medical Doctor, or other health professional. Gelley Chiropractic is not responsible or liable for injuries which may occur by performing any of the exercises given or diagnosis made by a user based on information within this site. Always consult your Doctor of Chiropractic, Medical Doctor or other health professional if you are in any way concerned about your health.