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Last name
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E-mail
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Home Phone
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Which service would you like to book an appointment for?
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Chiropractic Care - Dr. Nathalie Beauchamp
Low-Level Laser Therapy
PEMF Therapy (pulsed electromagnetic frequency)
Registered Holistic Nutrition
Gait Scan Analysis - Customized Orthotics Fitting
Functional and Nutrition Lifestyle Coaching
Registered Massage Therapy (not currently taking new patients)
Referral Source:
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Patient of the Clinic
Google Search/Website
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Other Health Professionals
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Do your currently fall under any of these categories:
Workplace Injury (WSIB) (Active Claim)
Motar Vehicle Accident (MVA)
RCMP
DND
Veteran (VAC)
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