FORMS

Save time and eliminate the hassles of filling out health history forms when you visit us. For your convenience, simply download and print the forms below. Just complete before you visit, and remember the forms when you visit us for the first time.

• New Patient Health History Form - Chiropractic/Acupuncture     Adult  (this form is fillable- download and fill it in, then print  it off or print to PDF and then you can save the completed document and email it to the clinic.  There are many free print to pdf software options, if you do not have a printer.)
• New Patient Health History Form - Chiropractic -Infant/Toddler (<3)
• New Patient Health History Form- Custom Foot Orthotics
• Patient Update Form- (this form is fillable- download and complete, then print it or print to PDF)
• Post Concussion New Patient Health History Form
• Post Concussion New Patient Questionnaire
• Baseline Testing Health History Form
• Baseline Testing Information 
• Registered Massage Therapy Health History Form​
• Registered Kinesiology Health History Form
• Authorization to Request Records
• MVA Extended health care information
• MVA Auto insurer information 
•  WSIB information
• Custom Foot Orthotics EHC information

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We have included the following standard claim forms to some of the most common extended health benefit providers in Ontario.

Chamber of Commerce
Desjardin
Canada Life
Greenshield
Industrial Alliance
Manulife EHC benefits
Medavie Blue Cross  EHC benefits
Medavie Blue Cross orthotics claim form
Sunlife
OTIP
Empire