Intake Forms

Universal Wellness & Rehabilitation Patient Intake Form

Please download and complete the following intake forms prior to your appointment for the Chiropractor, Physiotherapist, Massage Therapist, Holistic Nutritionist, Foot Practitioner and Acupuncture Provider. By completeing the forms as detailed as possible, you will assist your practitioner with understanding your health concern. Thank you.

Standard Intake Form (All Wellness Services):

  1. Vellore Fit for Life Wellness & Rehab Intake, Physical & Consent

Nutrition Forms

  1. Lifestyle Assessment Form
  2. Nutritional Counselling Rates and Packages

Join Our Monthly Fit for Life Wellness & Rehabilitation Newsletter

Our monthly health newsletter is emailed the first week of each month. To join the monthly health newsletter simply fill out the form below. Please write “newsletter” in the comments section of this form. Thank you.