Patient Forms

Completing the new patient paperwork is important so that we can learn about your health before your appointment.  There is a different form for each of our practices.

There are a few different ways you can complete and send us the necessary paperwork before your appointment:

  1. Complete the appropriate online form and click submit. The form will be submitted to us and we will be able to have it ready for you to sign when you arrive for your appointment.
  2. Print the appropriate form and fill it out by hand. From there, you can either fax it to (613) 237-3100, or e-mail it to us at reception@back2health4you.com prior to your appointment.

Please send the paperwork to the clinic at least 24 hours prior to your appointment.

There is paid parking in the lot on the west side of the building. Thank you for your cooperation, and we look forward to seeing you for your appointment!

New Patient Paperwork

Online SubmissionDownload PDF

Emergency New Patient Paperwork

Online Submission

New Patient – Pediatric (Ages 0-2)

Online SubmissionDownload PDF

Progress Check Questionnaire

Online SubmissionDownload PDF

Update for Patients Over One Year

Online SubmissionDownload PDF

Massage Therapy New Patient Paperwork

Online Submission

Naturopathic New Patient Paperwork

Online Submission

Foot Consultation Paperwork

Online Submission