Patient Intake Form

Interactive Patient Intake Form
The following is an interactive tool to provide Dr. Helper with key information regarding your current condition and medical history. Dr. Helper will then be able to formulate a leading diagnosis for your spine pain. Dr. Helper will personally respond to each intake form, providing you with the most likely diagnosis** for your spine problem, any necessary future investigations, and a probable treatment plan under his guidance.

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Please complete this form to the best of your abilities. If you are having any difficulties, feel free to contact Dr. Helper’s office at (604) 739-9695 for assistance.

Patient Intake Form last modified: July 24th, 2017 by Centric Health
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