All new patients, and patients returning after over 12 months or who have recently experienced significant medical changes, are encouraged to fill out the current intake form before your first appointment to save time.

You may download and return your completed form via e-mail to or print a copy and bring the filled-out form with you to your first appointment.

Before your appointment, if you are feeling ill or have come into close contact with someone who has or is suspected to have COVID-19, please stay home and notify Fred Samorodin at or 604-732-6323

Download instructions (if the form doesn’t automatically start downloading after clicking the download button):

– Right-click the download button of your preferred format (Word or PDF).
– Click “Save Link As…”
– From the folder window, note the correct document location and click “Save”
– Retrieve and open the Physiotherapy Intake file