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Intake Forms 

Please download and complete the appropriate intake forms prior to your initial visit.

Child Intake Forms (0-12 yrs)

Adult/Senior Intake Forms (12 + yrs)

Are you coming in for a pain management appointment? Please fill out the following form as well.
Brief Pain Inventory

 

Tel: 905-852-7704

 

26 Brock St East
Uxbridge ON
L9P 1P1

Monday: 9 am - 12 pm, 2 pm - 5 pm

Tuesday: 9 am - 12 pm, 2 pm - 7 pm

Wednesday: CLOSED

Thursday: 9 am - 12 pm, 2 pm - 7 pm

Friday: 1 pm - 5 pm

Saturday: CLOSED

Sunday: CLOSED

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