Kleinburg Integrative Health:
Let us help you.

KIH: Let us help you

Intake and Consent Forms

Click the Download link beside the label of the form you need to complete.

Naturopathic Forms

Adult Intake

Review of Systems

Adult Consent

Reassessment Intake

Children’s Intake

Consent of a Minor

Release of Records

IV Forms

IV Vitamin Drip Intake

IV Therapy Consent

IV Therapy Pre-Treatment Form

Chiropractic Forms

Intake and Consent

Massage Form


Benefits Form

Insurance Electronic Authorization And Consent

Online Payment Processing Form

Credit Card Authorization

Patient Diet Tracker

4 Day Diet Log