491 Church St. Suite 200

Toronto, ON M4Y 2C6 Canada

416-463-1500

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Online Forms

Church Wellesley Health Centre Rehabilitation offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form



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Monday:

8:30 am-7:00 pm

Tuesday:

8:00 am-8:00 pm

Wednesday:

8:30 am-7:00 pm

Thursday:

8:30 am-8:00 pm

Friday:

8:00 am-5:30 pm

Saturday:

By Appt.

Sunday:

By Appt.

Locations

Testimonials

Reviews By Our Satisfied Patients

  • "I've had chiropractic, physio and RMT treatment here and all were exceptional experiences. The practitioners are highly professional, knowledgable and interested in helping you. I highly recommend to anyone looking for a rehabilitation practitioner - in particular Dr Shafiei."
    -Wendy B.

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