Patient Information Needed to Fast Track Your Appointment

If this is an emergency appointment, please phone our clinic at 705-326-2200

Please fill out and submit the form below, it provides us with important information so we can fast track your appointment.

We will contact you within 24 hours to arrange an appropriate time for your consultation and/or treatment.

About You

Please Select

About Your Injury

Is This a Motor Vehicle Accident?

Is This Due to a Work Injury?

Date of Accident or Injury

Tests (X Rays, CT, MRI, Ultrasound) Done for Current Injury/Symptoms?

Name of Test/Date/Where it was Done

Additional Comments/Message

New Patient

If you are a new patient you may download and print our General Intake form to complete prior to your first visit.

Download General Intake Form

Returning Patient

If you are a current patient you may download and print our Patient Information Update form to complete prior to your next visit.

Download Information UPDATE Form

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