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FORMS and PAPERWORK
TREATMENT
CONTACT US
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FORMS and PAPERWORK
TREATMENT
CONTACT US
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  • Home
  • FORMS and PAPERWORK
  • TREATMENT
  • CONTACT US
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  • FORMS and PAPERWORK
  • TREATMENT
  • CONTACT US

Forms and Paperwork - PLEASE FILL OUT ALL FORMS AND EMAIL

Please fill out ALL of the following digital forms before your first appointment.

Email completed forms to: back_in_action@outlook.com

Please Read Consent form 

CCPA Consent Form (pdf)Download

This package of PATIENT INTAKE FORMS provides us with more history, context, and information about the condition you are experiencing.

BIA Patient Forms (pdf)Download

If you have any questions about how to fill out these forms, call or email us. 

If there are any technical limitations that may prevent you from filling in and submitting these forms digitally, please let us know. Paper copies of the forms will be provided for you to fill out before the appointment. You will need to arrive 15 mins earlier than your scheduled appointment time to ensure that all paperwork is filled out.

Back In Action Chiropractic and Rehabilitation

9249 Kennedy Rd.,Suite# 201 Unionville, ON L3R 6H8

(905) 943-9388

Copyright © 2026 Back In Action Chiropractic and Rehabilitation - All Rights Reserved.

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