Norfolk Chiropractic
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T: 519. 827. 0040
F: 519. 827. 0902
E: info@norfolkwellness.com
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Chiropractic New Patient Paperwork

 

If you are a new chiropractic patient to our clinic, you are required to complete a Health History form, a Case History form, and a Consent form prior to your initial visit. Please print and complete one of each of these forms by clicking on the appropriate link below. Please bring your completed forms to your initial visit.


Patient Health History
Confidential Case History - age 7 & up
Pediatric Case History - age 6 & under
Consent Form
Custom Made Orthotics Insurance Checklist


If you have been involved in a Motor Vehicle Accident, please click here for the necessary MVA paperwork

 

If you have been involved in a Workplace Accident, please click here for the necessary WSIB paperwork

 
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    New Patients Welcome!
    New Patients are always welcome. Call now to schedule your initial consultation and examination and experience our "hands-on approach to natural health care". Optimize your health ... Naturally!
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    Theralase Cold Laser Therapy
    Call our highly trained and knowledgeable Chiropractic Health Assistants for more information about our Laser Therapy Treatment. Schedule your Initial Consultation and Exam today!
  • Did You Know?
    Another Good Reason ....
    30 minutes of moderate exercise per day reduces the risk of Breast Cancer by up to 25 percent!
  • Did You Know?
    Good News for Runners
    A 30 year study has found that people who run require fewer joint repacements than those who didn't run!
  • Ongoing
    SHOCKWAVE THERAPY
    Call our highly trained and knowledgeable Chiropractic Health Assistants for more information about our Shockwave Therapy Treatment. Schedule your Initial Consultation and Exam today!
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Norfolk Chiropractic Wellness Centre
86 Norfolk St.
Suite 101
Guelph, ON
N1H 4J2
 
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