windsor chiropractor

chiropractor windsor

,

chiropractor

,

chiropractic

,

kinesio taping

,

acupuncture

,

custom knee braces

,

massage therapy

,

cold laser therapy

,

infrared sauna therapy

,

foot orthotics

,

biofreeze

,

stick intracell

physiotherapy home service

Dr. Roger Berton - Chiropractic Physician - Certified Kinesio Tape Instructor
 

519-979-2663
This e-mail address is being protected from spambots. You need JavaScript enabled to view it

1041 Lesperance Rd.  Tecumseh, Ontario  N8N 1W9
 

Massage patient online form

An accurate health history is important to ensure that it is safe for you to receive a massage treatment. If your health status changes in the future, please let me know. All information gathered for this treatment is confidential except as required or allow by law or except to facilitate diagnosis (assessment) or treatment. You will be asked to provide written authorization for release of any information.
 
 
Your Information:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Health HistoryPlease indicate any conditions you are experiencing, or have experienced:
 





 






 

 







 




 









 

 




 
 
 
 
 
 
 
 
 
 
 
 
 
 



 
 
 
 
 
 
I hereby consent to the Massage Theraphy treatments as described by my therapist. I understand and agree to the techniques that will be used, their desired effects and possible side-effects, and the anticipated duration of treatment. I recognize that I need to ask questions when unsure and that my therapist and I are partners in my health care program.
 
 
 

Meet Our Doctor

Dr. Roger Berton, D.C.sDr. Roger Berton, D.C, C.K.T.I.
Chiropractor
Certified Acupuncturist
Kinesio Tape Instructor
 

Experience The Difference!

A Healthy Way is dedicated to delivering a model of health which is person-centered rather than just disease-centered. Our friendly and dedicated staff will make you feel at home while helping you take charge of your own health!
 

Have Questions?

We're here to help. If you require immediate assistance, please give us a call at 519-979-2663.


For general questions, please email us at:
This e-mail address is being protected from spambots. You need JavaScript enabled to view it