If you have booked an appointment with Dr. Brock Easter @ Fusion Health Studio, please complete the form below and bring it to your initial visit.

 

Chiropractic Intake Form

 

 

2 thoughts on “New Patient Form

  1. I was referred by Yvonne Moir in regards to a foot movement issue.
    Wondering If I can make an aptmt at the summer hill clinic.

    Thank you,
    Tamara

  2. Hi,

    I’m interested in potentially taking the NeuroKinetic course in Vancouver in May. I notice you do PDTR as well. Do you teach that also? Before signing up for the course, I’m interested in speaking with you, if possible, on the differences in theory/application, etc?

    Thanks,
    Jon

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