Online Forms

Be Well Chiropractic Health & Wellness Centre offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Naturopathic Intake Form - Required

Download & Print Form



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Testimonial

Review By Our Satisfied Patient

  • "I have benefited tremendously from the chiropractic care I received from Be Well Chiropractic Health & Wellness Centre."
    John - Bradford, ON