Forms Download Page

 

DOWNLOADS (click the form  to download)


REGISTRATION FORM


This form must be filled in before

your intake visit. We are able to

bill your visit to  OHIP or or the

Régie de Québec


PATIENT HISTORY FORM


This form must be filled out

BEFORE your intake visit so that

you can review it with Dr. Bailey.

Fill it out at home prior to your visit.

If you have a medications list from a

pharmacy bring it with you. We do not

prescribe or renew medications.



INFORMED CONSENT


This form is given out at the first

group session and discussed then.

This is a replacement for it if it becomes lost.

It must be handed in on the second

day of the group





EXPANDED INFORMED CONSENT

(ten page form to share with your

doctor or other health care provider)


This is an optional expanded consent

explanation which you can share with your

doctor if he or she is unfamiliar with

AcuDestress. You may also use it to

understand the program better.