For new patients, click below to download and print the appropriate intake form. Filling this out prior to coming in for your first visit will save you time!
Acupuncture Form
Chiropractic Forms
Work Place Injury Forms & Information:
If you have been injured at work you need to:
1. Tell your Employer and fill out appropriate WCB paper work. www.wcb.ab.ca
2. Tell your Doctor of Chiropractic.
Your initial visit is covered by WCB regardless of whether or not they accept your claim. Please notify the Clinic within 48 hours of being injured. If you are able please print and fill out the following form for our records: Chiropractic Work Injury Form and bring it with you to your initial visit.
1. Tell your Employer and fill out appropriate WCB paper work. www.wcb.ab.ca
2. Tell your Doctor of Chiropractic.
Your initial visit is covered by WCB regardless of whether or not they accept your claim. Please notify the Clinic within 48 hours of being injured. If you are able please print and fill out the following form for our records: Chiropractic Work Injury Form and bring it with you to your initial visit.
Motor Vehicle Injury Forms & Information:
If you have been involved in a motor vehicle accident we can help make the process easier. Did you know you only have 10 days to file a medical claim? Chiropractors and Physical Therapists are legislated as primary contact health care professionals in every province in Canada. This means that patients can consult them directly, so no referral is required. We can submit all the paper work to your auto insurance provider, and design a specific treatment plan to help get you back to your pre-accident status as soon as possible. Injured patients are eligible for a combined maximum of 21 treatments of Chiropractic, Physical Therapy, Acupuncture, and Massage Therapy.
FORMS
You will need to complete a series of forms prior to your assessment and treatment with the Chiropractic Doctor or Physical Therapist. To save you time, please download and print the following forms prior to your visit:
Adult Chiropractic Health Record
These health records are only for patients who have NOT previously seen one of our Chiropractors or Physical Therapist depending on which therapist you will be having your assessment with.
Notice of Loss and Proof of Claim You may have already been sent and completed this AB-1 form for your insurance company. If not, please complete the form and we will fax it to your insurer on your behalf.
MVA Form This form gives us important information about the accident and your current state of health.
Completing these forms prior to your visit saves you time! Please fill out the forms to the best of your ability. If you require assistance or have any questions, please call us at 780-986-0566.
FORMS
You will need to complete a series of forms prior to your assessment and treatment with the Chiropractic Doctor or Physical Therapist. To save you time, please download and print the following forms prior to your visit:
Adult Chiropractic Health Record
These health records are only for patients who have NOT previously seen one of our Chiropractors or Physical Therapist depending on which therapist you will be having your assessment with.
Notice of Loss and Proof of Claim You may have already been sent and completed this AB-1 form for your insurance company. If not, please complete the form and we will fax it to your insurer on your behalf.
MVA Form This form gives us important information about the accident and your current state of health.
Completing these forms prior to your visit saves you time! Please fill out the forms to the best of your ability. If you require assistance or have any questions, please call us at 780-986-0566.
