New Patient Initial Appointment Request
Which service would you like to book an appointment for?
Chiropractic Care - Dr. Nathalie Beauchamp
Registered Massage Therapy
Low-Level Laser Therapy
PEMF Therapy (pulsed electromagnetic frequency)
Registered Holistic Nutrition
Customized Orthotics Fitting
Functional and Nutrition Lifestyle Coaching
Patient of the Clinic
Other Health Professionals
If applicable, name of the person who referred you?
Do your currently fall under any of these categories:
Workplace Injury (WSIB) (Active Claim)
Motar Vehicle Accident (MVA)
Other specific requests or questions?
Should be Empty: