Medicine Hat, AB
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Chiropractic Patient Intake Forms
Please download, print and fill out the form below. Bring the completed form with you to the appointment.
Chiropractic Patient Intake Forms(219 kb - Updated May 9, 2011)
Massage Patient Intake Forms(171 kb - Updated May 9, 2011)
Adobe Acrobat Reader is required to view and print the PDF file. The latest version is available directly from Adobe's site:
Download Adobe Acrobat Reader
If you are unable to download, print or complete the form, it is available at the clinic. Please arrive 10 - 15 minutes early in order to complete the form in time.
Chiropractic Patient Intake Forms(219 kb - Updated May 9, 2011)
Massage Patient Intake Forms(171 kb - Updated May 9, 2011)
Adobe Acrobat Reader is required to view and print the PDF file. The latest version is available directly from Adobe's site:
Download Adobe Acrobat Reader
If you are unable to download, print or complete the form, it is available at the clinic. Please arrive 10 - 15 minutes early in order to complete the form in time.
Cancellation Policy
12 hour notice of cancellation is required.
If no attempt is made to cancel and/or reschedule appointments, a penalty fee equal to the cost of the visit will be charged.
Cancellation fees are not covered by insurance.
Please arrive 5 minutes early for subsequent visits. Late patients will not have priority over patients who are present for their scheduled appointments. Full effort will be made to accommodate you if you are late, but not at the expense of other patients.
Please arrive 5 minutes early for subsequent visits. Late patients will not have priority over patients who are present for their scheduled appointments. Full effort will be made to accommodate you if you are late, but not at the expense of other patients.