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Spinal Decompression Therapy in Collingwood

Struggling with back pain, sciatica, leg pain, herniated disc, degenerative disc disease, bulging disc, tingling, numbness, neck pain, arm pain or spinal stenosis? Our spinal decompression therapy offers a non-surgical, safe solution to relieve pressure, improve mobility, and help you get back to your daily activities. Experience personalized care with proven results.

Complete the brief form below, and we will contact you promptly to arrange your appointment OR call us at: 705-444-7878

Non-Surgical Spinal Decompression Quuestionnaire

Non-Surgical Spinal Decompression Questionnaire

Please complete this online form to find out if you are a candidate for non-surgical spinal decompression.

First Name

Email

Last Name

Date of Birth

Phone

What is the best time to contact you?

Street Address

Apt/Suite

City

Province

Postal Code

Where do you feel primary pain? (check all that apply): * Required

Neck

Low back

Buttocks

Hip

Leg

Calf

Foot

Toes

Have you been diagnosed with any of the following:

Disc herniation

Disc bulge

Sciatica

Spinal stenosis

Disc degeneration spondylolisthesis

What modifier(s) most closely describes your pain (check all that apply): * Required

Dull

Sharp

Burning

Tingling

Shooting

Numbness

Throbbing

Have you contacted a medical doctor about your pain? *

Yes

No

Are you scheduled for back surgery? *

Yes

No

How long have you had the pain? *

Less than a month

More than 6 weeks

More than 6 months

More than 1 year

My condition and pain has affected my activities as follows (check all that apply):

Pain sitting

Pain standing

Trouble walking

Interrupted sleep at night

Decreased activities

Decreased pace

What best describes the frequency of your pain: *

Intermittent (0-25% of the day)

Occasional (26-50% of the day)

Frequent (51-75% of the day)

Constant (76-100% of the day)

Have you had back surgery? *

Yes

No

What time of day is your pain level greatest:? *

Morning

Afternoon

Evening

When is your pain at its worst? Describe how you feel and how you are affected:

When was the last time you felt really great?

I declare that the info I’ve provided is accurate & complete

Thank you for submitting, we will respond to you shortly!

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“An accident (almost a year ago) left me with severe neck and shoulder pain. After seeing Dr. Taylor for just a few weeks I can now move my neck left and right and my pain level has decreased. Also, Sydney keeps this office running smoothly where every appointment is on time. The atmosphere in this office is kind and welcoming. I highly recommend Dr. Taylor."

Liz Martin

Contact Us

Phone

Fax

Address

31 Simcoe Street

Collingwood, ON L9Y 1H5

Clinic Hours

Dr. Scott Taylor

Tuesday: 1pm–5pm

Wednesday: 8am–12 noon & 1pm–5pm

Thursday: 1pm–5pm

Friday: 8am–12 noon

First Name

Last Name

Email

Phone

Send us a message:

Thank you for contacting Taylor Wellness & Chiropractic. We will respond to your message shortly.

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