New Patient Form for Chiropractic & Registered Massage Therapy

New Patient Appointment Request

Please do not use this webform if you are an existing patient. Please use the existing patient form so that we can serve you better.

Please be advised that all personal information collected on this website will be kept in strict confidence in accordance with provincial and federal laws of Canada and will only be used during regular office procedures.

As a new patient, please also take a few minutes to print and fill out the New Patient History PDF Form before your first visit to enable us to serve you more efficiently.

Mandatory fields are indicated with an *

Name*
FirstLast
Phone (###)###-####
Email
Your preferred contact method*
- Phone
- Email
Treatment*
Preferred Practitioner*
Date: Preference*
Time*
: HH
MM
Please indicate who told you about our about our office.
Please note that by submitting this form, you agree to one of our staff members contacting you to confirm an appointment via your preferred contact method below

Book an Appointment

Existing Patients

Current patients can request an appointment by completing our online form, calling 613-564-9000, or by emailing wecare@ottawahealthgroup.com.

New Patients

New patients can request an appointment by filling out our new patient online form, calling 613-564-9000, or by emailing wecare@ottawahealthgroup.com.

As a new patient, please take a few minutes to print and fill out the New Patient History PDF Form before your first visit to enable us to serve you more efficiently.

New Patient Appointment Request

Please note that by submitting this form, you agree to one of our staff members contacting you to confirm an appointment via your preferred contact method below

Office Hours

Book an Appointment

Existing Patients

New Patients

Two Convenient Locations

Contact Us