Patient Intake Forms and Consent Forms
Select the best intake form to meet your needs.
Select the version for Pembroke if you plan on having your first visit at our Pembroke location, and Renfrew if you plan on having your first visit at our Renfrew location.
Generally, the long adult intake forms are preferred, as they give us a more comprehensive look at your case.
The short adult intake forms are available if a shorter form is needed.
The child intake forms are generally for children 12 and under.
Note: Please read the included consent forms. If there is anything you do not agree with, please strike it out and initial it. The email consent is completely optional. Many patients do not wish to communicate by email as it is not a secure means of communication.