Pro-Active Wellness & Injury Centre offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader┬« installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form

*Also, please bring in any other health records, exams, blood tests, or x-rays you have pertaining to your current condition.

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


New Patient Nutritional / Metabolism Form

*Also, please bring with you any other health records, exams, blood tests, x-rays or other information you may have available pertaining to your current condition.

This information reveals how your body is responding and functioning in response to your environment and will help us to help you.

Download & Print Form


New Patient Lung Profile

*Also, please bring with you any other health records, exams, blood tests, x-rays or other information you may have available pertaining to your current condition.

This information reveals how your body is responding and functioning in response to your environment and will help us to help you.

Download & Print Form


Member Wellness Registration Form – Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it into our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


Nutrition / Metabolism Questionnaire

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