McCallum Wellness Chiropractic Centre offers our patient form(s) online so you can complete it in the convenience of your own home or office.
- If you do not already have AdobeReaderÂ® installed on your computer, Click Here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) or bring it with you to your appointment.
New Patient Health History Form - Required
This let's us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
Family Health History Form - Required
This let's us know any family health issues going on.
Pediatric Health History Form - Required for all infants & children starting as new patients
Extended Health Benefits Check List: important for you to check and bring in on first visit so you know your options.
Patient Accident Report -MVA or WSIB
Please fill out this form as requested if you have been involved in a motor vehicle accident or a workplace injury, print it out, fill it out and PLEASE remember to bring it to the office.
Patient Testimonial Form
When you experience Chiropractic success during your care at McCallum Chiropractic Wellness Centre, Please fill out the Testimonial form and bring it to the office for Cathy to put in the "Our Patient's Speak" folder so others will learn of the wonders of Chiropractic! Thanks for your help!