New Patient Paperwork

Chiropractic Center for Health offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.

Chiropractic Intake Forms

  • Patient Health Record

    Click to Download

  • Child Health Record

    Click to Download

  • Prenatal Health Record

    Click to Download

Massage Intake Forms

  • Patient Health Record Muscle Therapy

    Click to Download

Motor Vehicle Accident Intake Forms

  • Notice of Loss & Proof of Claim (AB-1)

    Click to Download

  • Treatment Plan (AB-2)

    Click to Download

  • Low Back Pain & Disability Questionnaire

    Click to Download

  • MVA Symptom Checklist

    Click to Download

  • Neck Pain & Disability Index

    Click to Download

  • Personal Injury Patient Data Form

    Click to Download

WCB Intake Forms

  • Workers' Compensation Board Paperwork

    Click to Download

Financial Policy

  • Worker’s Compensation Board pays for Chiropractic Care in full.
  • Automobile Insurance companies cover the treatment of injuries sustained in an accident.
  • Private Insurance plans cover Chiropractic Care and Massage Therapy.

We accept cash, cheques, and charge.

If you have any questions regarding insurance or your coverage, please contact us.

OFFICE HOURS


Monday
9:00am - 7:00pm


Tuesday
9:00am - 7:00pm


Wednesday
9:00am - 7:00pm


Thursday
9:00am - 7:00pm


Friday
9:00am - 6:00pm


Saturday
9:00am - 4:00pm


Sunday
10:00am - 4:00pm

Chiropractic Center for Health

768-500 Country Hills Blvd NE
Calgary, AB T3K 4Y7

(403) 226-4433