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100 Year Lifestyle Chiropractor in Hamilton ON
Phone: (905) 573-6468
Make Your Health a Priority!

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Patient Forms


Please download these forms and complete them prior to your first visit. Bring the completed forms, along with your insurance information, with you and arrive for your appointment 15 minutes prior to your scheduled time. We look forward to seeing you!


Terms of Acceptance

Chiropractic health care terms of acceptance form.


Personal and Family Health History

Please fill this form and bring it with you on your first visit to our practice.


New Patient Application Form

Please download, print and fill this out before you first visit.



Massage Therapy Health History Form

Massage Therapy Health History Form



S.H.I.E.L.D Score

Find out where you fall; what areas are your strengths and which areas could use some more attention? And what can you do about it? . . .



Wellness Coaching

What is Wellness and why do we teach it? More importantly, how can it help you? . . .

Check out this detailed form for more information.