"*" indicates required fields

Referrers name*
We may use this phone number to call you if there are any questions or issues
What movements do you want to test?*
* Richmond clinic only ** Forest Hill clinic only. Also please note that we ask the patient to exert their 'maximal' effort. We warn them that there is a small chance it might exacerbate their condition. We reduce risk by ensuring that people to cease their effort if they experience any reproduction of their pain.
Please list if the patient has neurological signs, a history of previous spinal surgery and any significant diagnostic imaging data (i.e, severe lumbar canal stenosis, disc protrusion or extrusion, compression fracture etc). This information will assist in reducing the risk of aggravation during testing.
This field is for validation purposes and should be left unchanged.