Client Intake Forms

At Viva Health Centre, every treatment is customized to meet the needs of each client. The intake forms are the most effective way to relay key medical information as well as your areas of focus. All forms are available below to fill out prior to coming in so that we can maximize your time focusing on your health and wellness.

For your convenience, you can click on the links below to download the forms; please print, fill out, and bring to your appointment. Forms may also be faxed to the clinic at 902-469-5655 or emailed to booking@vivahealthcentre.com.

First Time Clients

First time in? Fill out these forms to maximize your treatment time:

Massage Therapy

• Massage Therapy Health History Form
• Body Awareness Chart

Naturopathic Medicine (Please complete and return this form to clinic at least 2 days prior to your appointment)

• Naturopathic Intake Form (Adult)
• Naturopathic Intake Form (Child)

Nutrition Counselling (Please complete and return this form to clinic at least 2 days prior to your appointment)

• 3-Day Food Record
• Nutrition Health Assessment Form

Returning Clients

Welcome back! Since you have already filled out the main forms, just update this one to tell us what is new with you:

• Body Awareness Chart