Patient Intake Forms

Patient intake forms need to be filled out for some services.

For your convenience, you may print these forms, fill them out and bring them with you when you arrive at the clinic . Intake Forms are required by all patients when utilizing any service for the first time and can also be filled out at the clinic.

Clinic Intake Form

*This form must be completed by all new patients.

Health History Form

*This must be completed by all Chiropractic, Physiotherapy, and Message Therapy patients.

Naturopathic Doctor Intake Form

*This form must be completed by all Naturopathic Medicine patients.

Adobe Acrobat Reader is required to view these forms and is available here.

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Phone: (416) 504-0628
Fax: (416) 504-2009
39 Lower Simcoe Street
Toronto, ON, M5J 3A6

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Hours of Operation

Monday: 8:00 am - 8:00 pm
Tuesday: 8:00 am - 8:00 pm
Wednesday: 8:00 am - 8:00 pm
Thursday: 8:00 am - 8:00 pm
Friday: 8:00 am - 8:00 pm
Saturday: 10:00 am - 3:00 pm
Sunday: 10:00 am - 3:00 pm