All forms are for both Chiropractic & Massage Therapy.

Please choose an intake form based on the patients’ age (intake form & personal information consent):

Initial Intake Form 0 – 5 yrs* & Personal Information Consent*

Initial Intake Form 6 – 15 yrs* & Personal Information Consent*

Initial Intake Form 16+ yrs* & Personal Information Consent*

For those with Extended Benefit Coverage, please download, print off and fill in the form below. This will help us determine if we can direct bill with your insurance company.

Extended Benefit Coverage Form

We may be able to Direct Bill for both Chiropractic & Massage Therapy.  Talk to us today about how we can help you.


IMPORTANT:
If you have been involved in a Motor Vehicle Accident please email us for all the forms that you will need. This will save time for you in the office. We are also a WCB approved centre.

Please bring along your ALBERTA HEALTH CARD and if relevant, any Extended Insurance information you may have, as we MAY be able to direct bill. Please ask upon your initial visit.