Patient Intake Form

Complete your intake online to expedite your first appointment. Takes about 10-15 minutes.

Completing your intake form in advance allows us to prepare for your visit and spend more time focused on your recovery during your first appointment.

Before You Begin

Please have the following information ready:

Personal contact information
Insurance details (WCB/MVA/private, if applicable)
Emergency contact information (optional)
Basic details about your injury or issue

Estimated Time: 10-15 minutes

You can save your progress and return later if needed.

Start Quick Intake Form (2–3 min)Start Guided Intake (AI-assisted)

Choose quick form if you want the fastest route. Choose guided intake if you prefer step-by-step help.

Privacy & Security

Your information is protected by industry-standard encryption and handled in accordance with HIPAA and PIPEDA regulations.

Read our Privacy Policy

Need Help?

Prefer to complete your intake over the phone or have questions? Our team is here to help.

Call (780) 250-8188