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Referral for Chiropractor Consult

Please complete the following referral form. Once submitted, your patient will be contacted to schedule an examination with the Chiropractor.

If you have any pertinent X-rays, CT or MRI reports, please fax them to 613-241-6828 or email them to hello@dawellnesscentre.com.

If you would like a copy of the examination results from the Chiropractor, please indicate so in the details section below.

We thank you for your referral and look forward to helping your patient reach their health goals.