Welcome to the family health and wellness centre. Our focus is to provide the highest standard of treatment, care and ethics to best suit the needs of our family community.
Please take a few minutes to fill out the patient form before your first appointment. Once finished, press submit and the form will automatically be sent to our clinic before your arrival.
If you have any question regarding this, please feel free to contact us at 403-289-8285 or email to us at email@example.com.
Once again, welcome and thank you for choosing Century Chiropractic Wellness Centre.
Name of Pediatrician
Date of Last Visit
At what age, in months, was the following introduced?
At what age was your child able to (in months):
Personal Illness History