Intake Forms

Please download the required Intake Form and bring with you to your next appointment.

Please print and sign our Privacy and General Clinic Policies

Privacy of Information and General Clinic Policy

Naturopathic Physician

ND General Intake Form
ND Patient Informed Consent and Acknowledgement
Chelation Therapy Consent
Intravenous Therapy Consent
ND Pediatric Intake Form

Medically Supervised Weight Loss Program

Pound a day Consent Form

Prolotherapy

Prolotherapy Consent Form

Acupuncture

Acupuncture Intake Form

Registered Massage Therapy

RMT Consent Form
RMT Intake Form

Counselling

Counsellor Intake Form
Counsellor Consent Form
Counsellor Consent for Release/Exchange of Info Form

Dietitian

Dietitian Intake Form

Aesthetics

General Intake Form
Botox Consent
Fillers Consent Form

Iron Infusion

Iron Infusion Referral Form
Iron Infusion Consent Form

BHRT

General Intake Form
Bio-Identical Hormone Consent Form

Microblading - Lip Tattoo - Lip Neutralization

Intake Form
Precare
After-care