Ajax Family Chiropractic offers our Initial Intake Forms online. You can complete a New Patient intake form in the convenience of your own home.
This information lets us know more about you --- your reasons for attending our office as well as your health history and current state of health.
Adult Intake Form or Child Intake Form (12 & under)Instructions: CLICK on appropriate form:
1) Complete it, Save it, and email it back to us
or
2) Print it, Complete it, and bring it in with you to your first appointment
Completed intake form(s) will save you time at your first appointment. Download AdobeReader® to make it a fillable form (it's free).