Start Your Health Journey

By completing the following questionnaire, we can speed up the process of having a Health Advisor review your information. Once reviewed, they will contact you to schedule a consult where you will work together to develop an annual plan that will help you achieve your health goals. If you simply wish to learn more about the program and what it offers, please provide us with your personal information (skip the rest of the form) and our Department Manager will contact you.

    Personal Information

    First name *

    Last name *

    Email *

    Phone number *

    Health Advisor Information

    What is your occupation?

    What is your ultimate goal of participating in this program? (check all that apply)
    General HealthWeight LossPerformanceOther

    What are your greatest barriers to achieving your goal(s)? (check all that apply)
    Family lifeWork scheduleInjuryFinancesOther

    Which of these allied health professionals are you most interested in working with? (check all that apply)
    Massage TherapistPhysiotherapistPsychologistDietitianKinesiologist (Personal Training)PhysicianSport Science

    When is your most stressful time of year and why?

    Do you have a health benefits package?
    YesNo

    If yes, who is your benefits provider?

    Based on your availability, what time of day would be convenient for you to book a consult?
    Mornings (6am-12pm)Afternoon (12pm-6pm)

    Who were you referred by?