Medical form (new patient)

Are you a new patient?

You must first complete a form collecting details about your condition before your first appointment at the clinic. To speed up the process, we invite you to fill out this form at home:

Download the form (PDF) by clicking here

Save the form on your computer before filling it *DO NOT COMPLETE DIRECTLY IN YOUR WEB BROWSER

Fill out and print the form.

Bring the form to the first appointment OR

Email it to

In case of cancellation of an appointment, please notify us by phone or email at least 48 hours in advance, otherwise you will have to pay a service fee.