Legal Name

Date of Birth

Insurance Co.

Insurance #

Area of concern

English

Re-Active Athletic Therapy

First Appointment - Coverage through Manitoba Blue Cross - Direct billing.
Please arrive 5 minutes prior to your treatment time to complete clinic intake forms.  If your plan requires a physician referral, it must be brought to the first appointment for direct billing.
Depending on the area to be assessed, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
First 30 minutes of the assessment is to determine abilities and limitations along with questions.  Remaining 30 minutes is for treatment.

Manitoba Blue Cross - Initial Assessment

Follow-up treatment session
A lapse of 3 months between treatments may be requested to book an initial assessment.
Depending on the area to be treated, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
Follow-up treatments are a combination of manual techniques, tools, modalities, stretches, exercises, etc. at the discretion of the athletic therapist.

Follow-Up Treatment

First sessions, or session for a new injury.
Please arrive 5 minutes prior to your treatment time.  Digital clinic intake forms will be emailed to you.
Depending on the area to be assessed, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
First 30 minutes of the assessment is to determine abilities and limitations along with questions.  Remaining 30 minutes is for treatment.

Initial Assessment

Follow-up treatment session - GreenShield - Direct billing
A lapse of 3 months between treatments may be requested to book an initial assessment.
Depending on the area to be treated, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
Follow-up treatments are a combination of manual techniques, tools, modalities, stretches, exercises, etc. at the discretion of the athletic therapist.

GreenShield - Follow-Up

First treatment session - Canada Life - direct billing. First treatment session.  
Please arrive 15 minutes prior to your treatment time to complete clinic intake forms.  
Depending on the area to be assessed, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
First 30 minutes of the assessment is to determine abilities and limitations along with questions.  Remaining 30 minutes is for treatment.

Canada Life - Initial Assessment

First Appointment - Coverage through Greenshield Canada - Direct billing.
Please arrive 5 minutes prior to your treatment time to complete clinic intake forms.  
Depending on the area to be assessed, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
First 30 minutes of the assessment is to determine abilities and limitations along with questions.  Remaining 30 minutes is for treatment.

GreenShield - Initial Assessment

Athletic taping of a general joint (ankle, wrist, thumb, knee, foot, turf toe, etc.).  Kinesiology tape, shoulder stabilization, or hip/groin wrap - $35 taping fee.

Athletic Taping

Follow-up treatment session - Canada Life - Direct billing
A lapse of 3 months between treatments may be requested to book an initial assessment.
Depending on the area to be treated, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
Follow-up treatments are a combination of manual techniques, tools, modalities, stretches, exercises, etc. at the discretion of the athletic therapist.

Canada Life - Follow-Up

Follow-up treatments - Manitoba Blue Cross direct billing
A lapse of 3 months between treatments may be requested to book an initial assessment.
Depending on the area to be treated, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
Follow-up treatments are a combination of manual techniques, tools, modalities, stretches, exercises, etc. at the discretion of the athletic therapist.

Manitoba Blue Cross - Follow-Up

Manitoba Public Insurance Accident Claim -  First Appointment - Direct billed
Please arrive 5 minutes prior to your treatment time to complete clinic intake forms.  
Depending on the area to be assessed, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
First 30 minutes of the assessment is to determine abilities and limitations along with questions.  Remaining 30 minutes is for treatment.

MPI Initial Assessment

Workers Compensation Board - First Appointment - Direct billed
Please arrive 5 minutes prior to your treatment time to complete clinic intake forms.  
Depending on the area to be assessed, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
First 30 minutes of the assessment is to determine abilities and limitations along with questions.  Remaining 30 minutes is for treatment.

WCB Initial Assessment

Manitoba Public Insurance Accident Claim - Follow-up session - Direct billed
Depending on the area to be treated, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
Follow-up treatments are a combination of manual techniques, tools, modalities, stretches, exercises, etc. at the discretion of the athletic therapist.

MPI Follow-up Treatment

Workers Compensation Board - Follow-up treatment - Direct billed
Depending on the area to be treated, comfortable loose fitting clothing can be brought.  Upper body (arm/shoulder/neck/back) - tank top, camisole, muscle shirt  Lower body (hip/low back/leg/ knee/foot/ankle) - loose fitting shorts
Follow-up treatments are a combination of manual techniques, tools, modalities, stretches, exercises, etc. at the discretion of the athletic therapist.

WCB Follow-up Treatment

Name

Show details for {{title}}

We use cookies to personalize content, share and measure ads, and improve your overall site experience. Update your choices at any time using the cookie icon at the end of this page. Read Setmore's

Select a time

Re-Active Athletic Therapy

Manitoba Blue Cross - Follow-Up

December 2024

Re-Active Athletic Therapy

Summary