Download and complete our new patient intake forms..

Patient Intake Forms

Our new patient intake forms can be downloaded below.  Please proceed as follows:

  1. Click the download button below the intake form heading you wish to download.  The form will download as a PDF document.
  2. The form that was downloaded can then be saved and then filled in electronically by clicking in the highlighted areas and typing.
  3. Once you have completed the form save it to your desktop. From here you have three options:
    1. Go to our APPOINTMENTS-General request page  or  APPOINTMENTS-Cancer request page,  complete the appropriate New Patient appointment request then click the SELECT FILE button. This will open a window that allows you to select your completed intake form from your desktop and attach it to your appointment request (drag & drop file is also available). Then SUBMIT and we will receive both the appointment request and the accompanying intake form. or
    2. Attach the completed form to an email using Outlook or other appropriate email software you may be using.  Send it to us at info@integratedhealthclinic.com or cancercare@integratedhealthclinic.com, depending on whether it is non-cancer or cancer related.
    3. Print the completed form and 1) bring it with you to your scheduled appointment, or 2) Fax to 604-888-8365.

If you have any questions bout this process, please give us a call at 604.888.8325.

Please note that the Aesthetics intake form cannot not be filled in electronically at this time. It will need to be printed, completed and scanned to email to be sent.

Cancer Intake Forms

Cancer - New Patient Intake Form

Download

Referral Forms

Cancer - Patient Referral Form

Download

IUD Referral Form

Download

Iron Infusion Referral Form

Download

Breast Thermography Referral Form

Download

General Health Intake Forms

Adult - New Patient Intake Form

Download

Youth - New Patient Intake Form

Download

Acupuncture - New Patient Intake Form

Download

Aesthetics - New Patient Intake Form

Download

Dr. Phimister - New Patient Intake Form

Download

Kaiden Maxwell DC - Chiro Intake Form

Download

OUR CONTACT INFO

VISIT IHC

Integrated Health Clinic
23242 Mavis Ave, Fort Langley, BC

CALL US

Ph: 604.888.8325
Fx: 604.888.8365

OUR EMAIL

Email from the Contact Us-Questions page.

Why come see us?

  • 16-Years in operation
  • 13-Naturopathic Doctors
  • 20-Admin/Lab support staff
  • 9-Departments encompassing a comprehensive scope of care
  • We practice evidence based medicine
  • We stress targeted & personalized treatment
  • We have caring & empathetic approach
  • We are proud of our professional & respectful staff

Our Operating Hours

  • Monday08:00AM - 8:00PM
  • Tuesday08:00AM - 6:00PM
  • Wednesday08:00AM - 8:00PM
  • Thursday08:00AM - 6:00PM
  • Friday08:30AM- 05:30PM
  • Saturday08:30AM- 05:30PM
  • SundayClosed

Laboratory services: Monday – Thursday: 9AM-6PM,  Friday & Saturday: 9AM-5PM