New Patient Paperwork

Full Potential Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

Patient Fees - We Direct Bill!

We are committed to providing you and your family the safest, effective chiropractic care possible in a loving and caring environment. We have established our financial policies to assist us in achieving that goal.



Initial Chiro Assessment


Chiropractic Adjustment


Active Release/Myofacial Release

$20 Additional Charge

Chiro Re-Examination


Pre-pay Wellness – 12 visits, 10% off regular visit fees

Contact Office For Details

WCB and MVA Claims

Contact Office For Details

Laser Therapy Initial Assessment


Laser Therapy Treatment


Massage – 60 minutes


Massage – 90 minutes


7:30am - 9:00am
2:30pm - 6:00pm

8:30am - 11:30am
2:30pm - 6:00pm

2:30pm - 6:00pm

2:30pm - 6:00pm

7:30am - 11:00am

Massage Only

Full Potential Chiropractic
5308 17 Avenue SW #11
Calgary, AB T3E 6S6
(403) 204-0084

Chiropractic Calgary AB Consumer Choice Award
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