If you are a new patient, please complete these forms prior to your appointment in order to save time in the waiting room. If you are unable to complete these form prior from your appointment, please call the clinic and let the front desk know.

Currently we are not accepting any new medical patients. Our waitlist is currently closed as it has reached maximum capacity.

We are however able to accept new patients' for ; Chiropractic, massage, acupuncture, prolotherapy and nutritional counselling

Health Questionnaire

Detailed description of all past and current health concerns and treatments to be reviewed with practitioner on first visit.

Outlines Stittsville Integrative Medicine Centre’s adherence to privacy issues and medical and personal information, and acknowledgment of centre’s ownership.

Stittsville Integrative Medicine Centre’s seven day diet and lifestyle diary

Forms

Achieving, maintaIning, and promoting health throughout life.

Stittsville Integrative Medicine Centre

HOME

TEAM

CONTACT

FORMS

OUR PHILOSOPHY

The Stittsville Integrative Medicine Centre is excited to provide a health clinic that offers many options in health care. Our mission is to assist individuals in achieving, maintaining, and promoting health throughout their lives irrespective of their current age or health condition.

We utilize scientifically supported health approaches from both mainstream medicine and Complimentary and Alternative Medicine (CAM).

Contact Us | Phone: 613-836-1711 | Fax: 613-836-1712

Outlines Stittsville Integrative Medicine Centre’s adherence to privacy issues and medical and personal information, and acknowledgment of centre’s ownership.

Chiro Consent

Click here for spreadsheet version

Detailed description of all past and current health history to be reviewed by therapist on initial visit

 

 

Massage History

Click here for Erin Case

Click here for Clarke Flynn