Below is the link to your New Client Form. Please complete and submit your form to us at least 48 hours (or as soon as possible) before your appointment.
Please note: we recommend saving your form periodically so you can return to it should there be any technical problems. There is an option to save your progress at the bottom of each page.
IMPORTANT: PLEASE USE A DESKTOP OR LAPTOP COMPUTER TO FILL IN THIS FORM. It is currently not compatible with smartphones and tablets.
Please note the form takes approximately 20 minutes to complete for Naturopathic clients. Acupuncture and Biomesotherapy clients need only fill in the first part of the form (about 5-10 minutes) as long as your condition is straightforward (i.e., not chronic or recurring). You can save your progress and return to it later if convenient (you will be emailed a link).
If you prefer, you can arrive at the clinic 30 minutes early and fill in a form provided at the counter, however please inform staff beforehand in case your appointment is the first of the day or immediately after a lunch break, as we need to ensure the clinic is attended for you. Please note we operate a paperless clinic (as much as possible) so we do appreciate it if you submit your forms online as it saves us time scanning your forms in to your electronic file prior to your appointment.
Keeping Your Personal Information Secure
Natural Pain Solutions uses CaptainForm, a reputable 3rd party provider owned by 123ContactForm (123FormBuilder) which has been providing form services since 2009.
Forms are loaded through SSL by default, which means that the data cannot be intercepted between your form and the CaptainForm servers.
All data transmitted and stored by CaptainForm is encrypted. While the Amazon Web Servers, where CaptainForm is hosted, are secure, using Data Encryption adds an extra step of security.
Your encrypted form is downloaded directly to our clinic reception computer and is then added to your digital file, which is stored on a cloud-based server provided by Sync.com. Again, all data is encrypted end-to-end. We chose Sync.com because of its excellent security protocols. Additionally, all clinic computers are protected by robust passwords.