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In order to make the best use of our time together, this form must be returned to our office no later than 2 WEEKS PRIOR to your scheduled appointment in order to KEEP your appointment.

This form may be filled out digitally, saved once completed and sent to us by email correspondence* as a file attachment. Alternatively, you may send us your completed form via fax (902)407-6601 , dropped off in person or sent by mail to:

508-5991 Spring Garden Rd.
Halifax, Nova Scotia B3H 1Y6

If we do not receive it by this time, we will assume you are no longer interested in keeping your appointment and your appointment time will be given to another patient. I will review all of the information again in our meeting, to ensure it is correct and in case there is anything you would like to add.

If you experience any difficulties with completing the initial consultation form, please do not hesitate to contact our office manager during office hours.

*If you opt to send it by email, you do so with the understanding that it is not possible to completely guarantee the security and confidentiality of electronic correspondence.