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
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Acupuncture Intake Form – Emily Dunn
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Chiropractic Intake Form – Dr Stacia Kelly
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Natural Allergy Testing Intake Form – Sue Taylor
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Counselling and Psychotherapy Consent Form – Sofia Lopoukhine
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Craniosacral Therapy Intake Form – Erica Sainsbury, Jessica Robillard and Pam Semple
Download Form
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
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Functional Medicine Intake Male Form – Dominick Hussey
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Functional Medicine Intake Form – Dr Athir Ghanim
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Herbal Therapy Consent Form – Abrah Arneson
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Hypnosis Intake Form – Derrick Barnes
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Massage Therapy Intake Form – Dragan Lazetic, Erica Sainsbury, Jessica Robillard, Pam Semple, Robert Black
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Naturopathic Medicine Intake Form – Dr Eric Viegas
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Naturopathic Medicine Intake Form – Dr Frances Pierantoni
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Osteopathy Intake Form – English – Carl Teychene-Coutet
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Osteopathy Intake Form – French – Carl Teychene-Coutet
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Osteopathy Intake Form – English – Dominick Hussey, Justine Gapihan and Robert Black
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Osteopathy Intake Form – French – Dominick Hussey, Justine Gapihan and Robert Black
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Reflexology Intake Form – Dragan Lazetic
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