Forms - Integral Health Clinic

forms - integral health clinic - ottawa oanada
Integral Health Clinic client intake forms.
If possible, please print and complete these forms prior to attending your initial consultation, and bring them to your appointment. If you are unable to do so please arrive 15mins early for your appointment to allow time for you to fill them out.

You will need to complete only 2 forms - the patient agreement and one form relating to your appointment.Thank you.

1. Client agreement-Intake Form:

Dr.Shahram Ayoubzadeh/Julie Goldring, ND

Please print, complete and bring this form with you (to be completed and signed by all clients).
» Adult Homeopathy Intake Form
» Pediatric Homeopathy Intake Form
2. Acupuncture:
Pejman Ayoubzadeh
» Intake form
4. Massage, Registered Massage Therapy, Hot Stone, Relaxation:

Pejman Ayoubzadeh
» Intake form
5. Matrix Repatterning:
Pejman Ayoubzadeh
» Intake form
6. Naturopathy & Homeopathy:
Dr Shahram Ayoubzadeh
You will need to complete the short form below.
Please ONLY complete the long form if you are asked to do so by Dr Shahram Ayoubzadeh. If you do complete the Long intake form please ensure we receive it in the office at least 2 working days before your appointment to allow Dr Ayoubzadeh time to read it.
» Long Adult Homeopathy Intake Form