About Chiropractics Videos FAQs Useful Links Dr. Denis Rioux, Chiropractor D.C. 24, Principale St. #201 Gatineau - Aylmer (Québec) J9H 3L1 Tel :  (819) 684-3555 Fax : (819) 684-2116 Confidentiality Policy

Chiropractic is the natural alternative to medicine or surgery. Please answer the following questions to help Dr. Denis Rioux know more about your symptoms. Once received, one of our specialists will contact you to arrange for an appointment to discuss your condition in person. Please note that all fields in bold are required. Name: Telephone: (eg: 999-999-9999) Email: Have you suffered from a car accident, sports injuries, or a serious fall?   Yes No Do you experience stiffness or friction in one of your joints?   Yes No When moving one of your limbs, your neck or your back, do you feel your movement is limited?   Yes No Have you noticed any swelling and redness with your shoulder, knee, elbow, wrist, finger or ankle?   Yes No Do you feel pain when you fold your leg, arm, finger, or when you move your shoulder, wrist, ankle or your pelvis?   Yes No Do you find yourself taking pain-killers (aspirin or other) to ease soreness or pain in your joints?   Yes No While waking up in the morning, do you feel pain in your back which disappears once you get up?   Yes No Did you have to slow down the number or duration of your activities due to a physical incapacity?   Yes No Is it hard for you to turn your head without moving your torso?   Yes No Do you find it difficult to bend in order to pick up small objects from the floor?   Yes No Does your back hurt after strenuous exercise?   Yes No Where did you hear about us? Comments:   Add me to your newsletter Your email will be kept in complete confidentiality and will not be distributed, sold or used for any end other than for us to communicate with you. Confidentiality Policy

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