Note: please save these PDF forms to your computer before filling them out.
Naturopathic Medicine Forms:
Adult Intake Form
Pediatric Intake Form
Medical Doctor Forms:
Migraine Disability Assessment Test
Patient Health Questionnaire
World Health Organization Disability Assessment
Headache Impact Test
Sheehan Disability Scale
Generalized Anxiety Disorder Scale
At Aspire Medicine we are happy to submit to many benefits providers on your behalf. (Please note: We cannot guarantee the amount each provider will cover) We accept Cash, Cheque, Debit, Visa & MasterCard.
We require 24 hours notice for canceled or rescheduled visits. If less than 24 hours notice is given, the full cost of the scheduled visit will be charged. Aspire Natural Medicine appreciates your understanding on this matter.
If you have booked your initial consultation at our clinic, we need to receive your intake forms at the office 1 week prior to the initial consultation. You can send these via fax, email, or drop them off. If we do not have forms in our office 1 week prior to the visit it will be canceled and filled with another patient.