Enabling you and your family to heal in mind, body & spirit

Before your first visit with one of our practitioners, we ask that you complete a health history intake form. This will help us to ensure the best possible treatment for you.

First time at our clinic? You will also need to complete the client agreement.

You can download the relevant forms below and fill them out before you come. If you are unable to do this, please arrive 15 minutes early for your appointment to allow time to do so.

 
Client Agreement Form – English
Download Form
Client Agreement Form – French
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Acupuncture Intake Form – Dr Stacia Kelly DC
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Acupuncture Intake Form – Emily Dunn L.Ac
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Chiropractic Intake Form – Dr Stacia Kelly DC
Download Form
Natural Allergy Testing Intake Form – Sue Taylor
Download Form
Counselling and Psychotherapy Consent Form – Sofia Lopoukhine
Download Form
Craniosacral Therapy Intake Form – Erica Sainsbury RMT, Jessica Robillard RMT, Pam Semple RMT
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Emotional Blueprint Consent Form – Deborra Cameron
Download Form
Energy Healing and Reiki Intake Form – Debra Ramsay and Sue Taylor
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Functional Medicine Female Intake Form – Dominick Hussey DOMP
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Functional Medicine Intake Male Form – Dominick Hussey DOMP
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Herbal Therapy Consent Form – Abrah Arneson
Download Form
Hypnosis Intake Form – Derrick Barnes RSW
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Massage Therapy Intake Form – Diana Truesdell RMT, Dragan Lazetic RMT, Erica Sainsbury RMT, Jessica Robillard RMT, Pam Semple RMT, Robert Black RMT
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Naturopathic Medicine Intake Form – Dr Eric Viegas ND
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Naturopathic Medicine Intake Form – Dr Frances Pierantoni ND
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Nutrition Intake Form – Emily Stott RHN
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Osteopathy Intake Form – English – Carl Teychene-Coutet DOMP
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Osteopathy Intake Form – French – Carl Teychene-Coutet DOMP
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Osteopathy Intake Form – English – Dominick Hussey DOMP, Justine Gapihan DOMP and Robert Black DOMP RMT
Download Form
Osteopathy Intake Form – French – Dominick Hussey DOMP, Justine Gapihan DOMP, Robert Black DOMP RMT
Download Form
Psychotherapy Consent Form – Sofia Lopoukhine
Download Form
Reflexology Intake Form – Dragan Lazetic RMT
Download Form