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I

 understand all the benefits, risks, side effects, nature of assessment and following treatment for Physiotherapy Services provided by PhysioRehab Group. I consent my Physiotherapist to disclose my personal health information to others involved in my care (Payers – Insurance company, Physiotherapy support person, if required & referral sources) and my health care provider (Physician). I understand the importance of Physiotherapy assessment, treatment and an exercise program prescribed by my Physiotherapist for the improvement of my present condition (Injury / Illness) and understand the consequences of not following the treatment and exercises. I can ask questions about the assessment, ongoing treatment, and the exercise program at any point of time during the process.I also understand that I have the right to withdraw my consent at any time during assessment and following treatment but does not apply to personal and personal health information that has already been collected, used, or disclosed by PhysioRehab Group.

I consent to be contacted via email, text message or calls for the purpose of providing me with information and communication related to my telecare, booking, and confirming appointments.

​Consent for the following:

I agree to the above-mentioned consent and would like to go ahead with the Physiotherapy services with PhysioRehab Group.

Signature of the Client (Guardian if under 16 years)

Your content has been submitted

Email: info@prgwhitby.com

Tel: (905) 995-2700

728 Anderson St Unit 6/6A, Whitby, ON L1N 3V6

Clinic Hours

Monday-Friday: 9AM to 8PM
Saturday: 9AM to 6PM
Sunday: By Appointment Only

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Physiotherapy, RMT
and Personalized Care
  • Physiotherapy

  • Posture Correction Therapy

  • Orthopedic Rehabilitation

  • Sports Injury Rehabilitation

  • Post-Surgical Rehabilitation

  • Manual Therapy

  • Sports Performance Enhancement

  • Custom Orthotics

  • Massage Therapy

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