Intake Forms

New Patient Intake Forms

Welcome to pureBalance Wellness · Cancer Care. We are happy to know that you have chosen our centre for your health journey.

Please make sure all forms specific to your service are downloaded and completed prior to your visit. To view these forms you must have Adobe PDF Reader, if you don’t have it click here to visit the Adobe website and download it.

Naturopathic Adult & Child

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Naturopathic Infant (Up to 12 mos)

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Massage Therapy

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Chiropractic Care


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Colon Hydrotherapy (Colonic)

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Energy Healing

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