Women's Balance Health
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Intake forms 
PDF documents, you have to print an complete by hand.   Word can be opened and completed on your computer. 


Children's Intake forms:  (PDF or WORD FORMAT) - 

Please remember to download the Preparation document for your childs' first visit. 
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pediatric_intake_form.pdf
File Size: 99 kb
File Type: pdf
Download File

pediatric_intake_form.doc
File Size: 55 kb
File Type: doc
Download File


Adult Intake forms clients: (PDF ONLY)  (Please print & complete both  the intake and consent form)
wbh-acupuncture-intake.pdf
File Size: 62 kb
File Type: pdf
Download File

statement_of_consent.pdf
File Size: 82 kb
File Type: pdf
Download File

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  • Home
  • Women's Health
    • Fertility
    • Pregnancy
    • Birthworker Services
    • New Parents >
      • Placenta Encapsulation
      • Post Partum
    • End of Moon Time
  • Kids Health
  • About/Contact Nadia
  • Testimonials
    • Submit a Testimonial
  • Intake Forms
  • Indigenous Birth
  • Lactation Counselling