Intake Forms

You may complete an intake form and send it via email with the link below, or fax the form to the clinic or you can arrive 15 minutes prior to your initial visit to complete it in office.  All information sent is kept confidential.

  Adult Intake Form      Paediatric Intake Form 

  Email completed intake form here

Note: If you are the parent/legal guardian of a child under 12 you may fill out the paediatric intake form.