Give us a call

Lower Mainland:
604.734.7125
Vancouver Island:
250.595.7125
Southern Interior:
250.861.7125

Patient Intake Form

Inspire Health flower

Please complete this form prior to attending your first individual appointment with a clinician at InspireHealth.

Tips for completing the form

  • You can save your form and continue at a later time. Your information is secure and encrypted. Just scroll down and click ‘save and continue later‘. You will then have the option to enter your email to receive a link and continue later.
  • We will not receive the form until you click the submit button at the end of the form. If you prefer, you can download a PDF copy of this form (coming soon) and email it back to us at info@inspirehealth.ca.