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.


9:00am - 7:00pm

9:00am - 7:00pm

9:00am - 7:00pm

9:00am - 7:00pm

9:00am - 6:00pm

9:00am - 4:00pm

10:00am - 4:00pm

Chiropractic Center for Health

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

(403) 226-4433