589 St Anne's Rd.
Winnipeg, MB. R2M 5A9
Winnipeg Chiropractors Dr.'s Jason and Danella Whittaker
Typical Day Activities
The following items are about activities you might do during a typical day.
Does your health now limit you in these activities? If so how much.
How has your health affected your daily routine?
During the past 4 weeks, have you had any of the following problems with work or other regular daily activities,
as a result of your physical health?
Living with Pain
The following items are how much pain you experience in a typical day.
Your Emotional Health
The following items are about your emotional health.
Final Health Questions
Answer these final questions about your health as honestly as possible.
The Winnipeg Chiropractors at Family First Chiropractic & Wellness Center. 589 St Anne's Rd. Winnipeg, Mb. R2M 5A9. (204)254-1313. Copyright 2006 All Rights Reserved. Sign In