Your first visit doesn't have to be stressful
If you've been dealing with dizziness, vertigo, or balance problems, booking a vestibular assessment is a great first step. Knowing what to expect can help you feel more comfortable and get the most out of your appointment. Here's a detailed walkthrough of what happens before, during, and after your first visit at Burlington Vestibular Therapy.
Before your appointment
A little preparation goes a long way. Before you arrive, gather the following:
- A list of your current medications — include prescription drugs, over-the-counter medications, and any supplements. Some medications affect the vestibular system, so this helps your physiotherapist understand the full picture.
- A symptom diary — if possible, keep a brief record of your symptoms for a few days before your visit. Note when episodes occur, how long they last, what triggers them (head movements, rolling over in bed, busy visual environments), and how severe they feel on a scale of 1 to 10.
- Any relevant medical reports — if you've had imaging, hearing tests, or previous assessments from your physician or ENT, bring copies or have them available.
- Your insurance information — Burlington Vestibular Therapy offers direct billing to most major insurance providers, so have your plan details handy.
You do not need a doctor's referral to book a vestibular physiotherapy appointment in Ontario. You can self-refer and come directly.
What to wear
Wear comfortable clothing that allows you to move freely. You'll be asked to change positions during the assessment — sitting, lying down, and standing — so avoid restrictive clothing. Flat, closed-toe shoes with good grip are best, as part of the assessment involves standing and walking tasks.
The assessment
Your first appointment typically lasts 45 to 60 minutes. It's thorough by design, because vestibular conditions require careful evaluation to identify the specific cause of your symptoms.
History taking
Your physiotherapist will start by asking detailed questions about your symptoms. Expect to discuss:
- When your symptoms started and how they've changed over time
- Whether you experience true spinning vertigo or a more general dizziness or unsteadiness
- Specific triggers and patterns
- Your medical history, including any head injuries, ear infections, or migraines
- How your symptoms affect your daily life — work, driving, sleep, and activity levels
This conversation is essential. Vestibular conditions often share overlapping symptoms, and the history frequently points toward the correct diagnosis before any physical testing begins.
Oculomotor exam
Your physiotherapist will assess your eye movements. The vestibular system is directly connected to the muscles that control your eyes, so abnormal eye movements (called nystagmus) are one of the most important diagnostic clues. You may be asked to follow a target with your eyes, look quickly between two points, or keep your gaze fixed while your head is moved.
Positional testing
If BPPV is suspected, your physiotherapist will perform specific positional tests such as the Dix-Hallpike manoeuvre. This involves guiding you from a seated position to lying back with your head turned to one side. The test checks whether displaced crystals in your inner ear are triggering vertigo. It may briefly reproduce your symptoms — this is expected, and it's actually helpful because it confirms the diagnosis and tells your therapist exactly which ear canal is involved.
Balance assessment
You'll be asked to stand in various positions — feet together, on one foot, with eyes open and closed — to evaluate how well your balance systems are working. Your physiotherapist may also assess your gait and how you respond to head movements while walking. These tests help determine whether your vestibular system is properly coordinating with your vision and body position sense.
Additional tests
Depending on your symptoms, your physiotherapist may also screen for vestibular neuritis, cervicogenic dizziness (neck-related), or vestibular migraine. The assessment is tailored to your specific presentation.
After the assessment
Once testing is complete, your physiotherapist will explain their findings and discuss a working diagnosis with you. You'll receive:
- A clear explanation of what's causing your symptoms — in plain language, not just medical terminology.
- A treatment plan — this may include in-clinic techniques (such as repositioning manoeuvres for BPPV), a progressive vestibular therapy exercise programme, or a combination of both.
- Home exercises — most vestibular rehabilitation involves exercises you do at home between sessions. Your physiotherapist will walk you through each exercise and make sure you're comfortable performing them independently.
- A recommended follow-up schedule — depending on your condition, you may need anywhere from one to several sessions.
Common questions
Will the assessment make me dizzy?
Some tests, particularly positional testing for BPPV, may briefly reproduce your symptoms. This is intentional and diagnostically valuable. Any provoked dizziness is typically short-lived, lasting seconds to a couple of minutes. Your physiotherapist will explain each test before performing it and will monitor you throughout.
How many sessions will I need?
It depends on the condition. BPPV often resolves in one to three visits. Conditions like vestibular neuritis or vestibular migraine typically require a longer course of vestibular rehabilitation — often four to eight sessions over several weeks. Your physiotherapist will give you a realistic estimate after your initial assessment.
Do I need a referral?
No. In Ontario, you can access physiotherapy directly without a physician referral. You're welcome to book your first appointment at any time.
Does insurance cover vestibular therapy?
Most extended health plans in Ontario cover physiotherapy. Burlington Vestibular Therapy offers direct insurance billing, so in most cases you won't need to pay upfront and submit receipts yourself. Check with your plan for any visit limits or coverage details.
Ready to book?
The sooner vestibular symptoms are assessed, the sooner treatment can begin. Many conditions improve significantly with the right intervention.
Book your vestibular assessment or call us at 905-635-5711. No referral needed.