Accessibility View Close toolbar

Primary Location

7-676 Monarch Ave,

Ajax, ON L1S4S2 Canada

905-683-8695

Online Forms

Harwood Chiropractic Centre offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Chiropractic New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Click Here to Download & Print Intake Form Page 1 - Required

Click Here to Download & Print Health History Intake Form Page 1 - Required

Click Here to Download & Print Health History Intake Form Page 2 - Required -Under construction

Click Here to Download & Print Informed Consent Form - Required

Click Here to Download & Print Informed Consent Form for Acupuncture


Registered Massage Therapy(RMT) Intake Form - Required

Click Here to Download & Print Form

Registered Massage Therapy(RMT) Medical History Form - Required

Click Here to Download & Print Form


Download the Free AdobeReader®

CONTACT US TODAY

We look forward to hearing from you

Location

Find us on the map

Office Hours

Our Regular Schedule

Ajax Office

Monday:

8:30 am-7:00 pm

Tuesday:

9:00 am-12:00 pm

2:00 pm-7:00 pm

Wednesday:

8:00 am-3:00 pm

Thursday:

9:00 am-12:00 pm

2:00 pm-7:00 pm

Friday:

8:00 am-4:30 pm

Saturday:

9:00 am-12:00 pm

Sunday:

Closed