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 completed online (or downloaded and completed for chiropractic care) prior to your visit. To view the chiropractic form you must have Adobe PDF Reader, if you don’t have it click here to visit the Adobe website and download it.

Naturopathic Infant (Up to 12 mos)

Online Intake Form for Naturopathic Infant

Colon Hydrotherapy (Colonic)

Online Intake Form for Colon Hydrotherapy

Book Your Appointment Online Select services available.Book Now!