Online Forms

We offer our paperwork on line so you can complete it in the convenience of your own home. 

We kindly request you use black ink to complete the forms.

New Patient Intake Form

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?

  Download & Print Form

AB1 Notice of loss for MVAs (Motor Vehicle Accident)

If your health issue is the result of a car accident, we need some additional information.

  Download & Print Form

If you haven't already, ensure your insurance company knows you or your passenger are injured.  These forms and the initiation of a claim are time sensitive.  Your insurance company needs to know about your injury within 10 days of your car accident. Also, please be aware that under current Alberta legislation, we are able to direct bill your insurance company for treatment related to your recent car accident.  However, the process needs to be started within the ten day period mentioned to prevent out of pocket expenses for treatment.  Please give us a call if you need more information at (403) 282 - 5590.

Massage Therapy Intake Form

If you are coming to see us for a massage, please let us know what you are coming in for and any important information needed prior to your session.

  Download & Print Form

Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

If chiropractic sounds promising, we encourage you to have a firsthand experience in our NW Calgary practice. It’s easy to get started. Call today.

North Hill Centre Chiropractor : Dr. Zahirra Kara
#1766, 1632 - 14th Avenue NW, Calgary, Alberta | (403) 282-5590

Serving Briar Hill/ Hounsfield Heights, West Hillhurst, Capitol Hill and Mount Pleasant