New Patient Forms

Orleans Gardens Chiropractic offers our New Patient Form(s) online so you can complete them at your convenience prior to your first visit in our office.

• If you do not already have AdobeReader® installed on your computer, Click Here for a FREE download.
• Download the necessary form(s), print it out and fill in the required information.
• Bring the completed forms with your to your first visit or fax us your completed forms at 613-830-4492.

This let’s us know your health history and current health situation.  Please complete both the New Patient Health History Form (Adult or Child) and the Informed Consent Form.

New Patient Health History Form - Adult 

Informed Consent Form

Child Health History Form

Dossier Confidentiel du Patient - français

MOTOR VEHICLE ACCIDENT

Should your injury be due to a motor vehicle accident, please complete the following documentation:

Motor Vehicle Accident Forms 

Neck Disability Index Questionnaire

The following is the link to the Insurance Board of Ontario regarding motor vehicle accidents benefits

New Patient Introductory Offer

The New Patient Offer entitles you to receive a comprehensive Chiropractic consultation, spinal  & postural examination including spinal x-rays (if necessary) for only 80$.  The full value of the first visit is $170.00.   Take advantage of this great offer today!  Click here to schedule  your first visit in our office.

Your First Visit

If you are trying to figure out what to bring, or what to expect on your first visit (examination/consultation) to our office, look no further.  This guide is written just for you, along with a map so you can easily find us.

What should I bring?  Current x-rays or MRI results if you have them (helpful, but not necessary)

What should I wear? Comfortable clothing that allows you to stretch/ bend freely.  Should x-rays be required, you will be asked to change into a gown and shorts and remove any jewelry.  Therefore, we recommend you leave necklaces/chains and earrings at home.

How long is the first visit?  Plan on approximately 45 minutes to one hour, depending on the complextity of your case. 

Should I show up early to fill out paperwork?  We offer you the opportunity to print off the necessary paperwork and complete them in the comfort of your home.  This will save you from arriving early at the office to fill out the paperwork and will reduce your waiting time. 

Will I need a follow-up visit?  The purpose of your examination is to find the exact cause and location of your problem.  Often times, it is helpful to have x-rays of your spine to confirm other examination findings.  A follow-up Report of Findings visit will be scheduled to discuss the examination and x-ray results, what we can do to help, how long it may take and how much it will cost.

How long will I need care?  How long you will need Chiropractic care depends on your goals.  Some people just want temporary relief.  Others want to retrain and strengthen their spine so they can avoid a relapse.  A growing number of people adopt a schedule of periodic wellness visits so they can be their very best. 

How much will it cost? That's up to you, based on how far you want to take your care. 

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Location:

We are located at the intersection of Orleans and Jeanne d'Arc Blvd in the Independent Grocers Plaza. 

If you driving from Highway 174, exit Jeanne d'Arc Blvd and go south up the hill to Orleans Blvd. 

If you are driving from Innes Road, go north on Jeanne d'Arc to Orleans Blvd or go north on Orleans Blvd to Jeanne d'Arc.

1615-6 Orleans Blvd, (613) 830-3337

For a Driving Map to our office Click Here