1640 16th Ave NW #103. Centre for Chronic pain and wellness care. 403 282 3766

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  • Home
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  • Contact and Hours
  • Clinic Forms
  • Blue Cross
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  • Provider Connect
  • Telus Health
  • The claims xchange
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  • Netcare Alberta
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Admittance Forms for North Hill Massage and Chiropractic

Please complete these Chiropractic forms as best as you can and bring them with you to your chiropractic adjustment .  They are in both open office format and windows format.  If you don't have these installed please download to your desk top and right click and press "open with.." you may have a windows default word processor.  If you don't have a printer to print out the admittance forms just arrive a few minutes early.

1. Admittance-Form (docx)

Download

1. Admittance-Form (odt)

Download

2. Health-History-Questionnaire (1) (docx)

Download

2. Health-History-Questionnaire (odt)

Download

3. Systems-Review-Form (docx)

Download

3. Systems-Review-Form (odt)

Download

4. Informed-Consent (pdf)

Download

Accident Benefit Claim - MVA Forms (pdf)

Download

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