Online Forms

Courtenay Family Chiropractic 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 (897-1409 - remember our 250 area code) or scan & email to - (you must remove all spaces from the email for us to receive it) your printed and completed forms, or bring it with you to your appointment. **These forms must be completed prior to seeing the Doctor**


New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns or goals regarding health & wellness can we help you with? Let us know! Click the link below to view & print your health history forms. You can fill these out at your leisure at home before your initial consultation. Don't forget to bring them with you! If left at home you will be required to fill them out again in our office.

Adult Health History Form

Children's (under 18) Health History Forms

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