Please click here to download your new patient forms

Please complete all questions on the form in blue or black pen
These are completed prior to your first visit only
Please do so neatly and legibly
Please do not fold your forms
Incomplete forms will not be accepted
Remember to make an appointment before you come in

Important

These forms will ask for all current or past health conditions. These facts must be known if we are to provide the safest and most appropriate treatment.

Some may initially feel our forms are too thorough. They are of the depth recommended by the Canadian Chiropractic Association to enable the practitioner to provide the most appropriate care possible.

We take the extra effort to protect your health. Please answer all questions truthfully and completely.

Please list all medications and all previous accidents, injuries, surgeries or illnesses where indicated. Not doing so may cause a delay during the interviewing process.

Your First Visit Why Do We Ask?

Custom Foot Orthotics

Smaller Carbon Footprint: (no matter how big your feet are)

Now you don't have to plant a tree when you buy your orthotics. They are locally manufactured at Kintec, arriving sooner and with less environmental impact.

CLICK HERE TO READ MORE