Downloadable forms

Having these forms filled in advance make new client orientation faster!
Download these pdf’s, print and complete!

Patient Health History Form (pdf)

Please fill these forms out to the best of your ability so we may serve you better knowing your full and relevant health history.

*Consent forms are filled out in person at the time of your appointment.

Application for Direct MSP Billing (pdf)

For B.C. residents who qualify for premium assistance (an income of $30,000 or less) Medical Services Plan (MSP) will cover $23 per visit to a maximum of 10 visits (acupuncture, physiotherapy, chiropractic) per calendar year.

Heart & Hands Health Collective can bill directly on your behalf for up to
10 Community Acupuncture sessions depending on eligibility and coverage.