Mandala Center for Health and Wellness
  • Welcome
    • Covid 19 clinic safety plan
    • Testimonials
  • Book Online
  • Who We Are
    • Acupuncturists >
      • Dallas Nye
      • Jacqueline Rioux
      • Lori Race
    • Massage Therapists >
      • Caitlin Sartorio
      • Cara Legacy
      • Carly Britton
      • Emiko Ihara
      • Meghan Kelly
      • Nicole Baker
      • Steve Ferris
    • Counsellors >
      • MXN Mens Therapy Network
      • Shirley Graham
  • What we do
    • Acupuncture >
      • Pain Conditions & Injuries
      • Women's Health, Fertility & Pregnancy
      • Cosmetic Acupuncture
    • Hypnotherapy
    • Clinical Counselling
    • Massage Therapy
  • Rates
  • Insurance FAQ
  • Connect With Us
  • Career opportunities
Welcome to Mandala!

Forms

​Once you are booked in for your initial visit into the clinic, or nifty computer software will automatically send you a confidential health history form to fill out.  Of course, if you rather wish to fill out a paper copy we have those at the clinic as well.

Acupuncture

Lori Race's Forms
Lori's Acupuncture Initial Intake
File Size: 2731 kb
File Type: pdf
Download File

Lori's TCM Intake
File Size: 1361 kb
File Type: pdf
Download File

Lori's Fertility Intake
File Size: 1944 kb
File Type: pdf
Download File

Dallas Nye's Forms
Dallas' Acupuncture Initial Intake
File Size: 129 kb
File Type: pdf
Download File

Verena McCrae's Forms
Verena's Acupuncture Initial Intake
File Size: 931 kb
File Type: pdf
Download File

Herbal Medicine Initial Intake
File Size: 231 kb
File Type: pdf
Download File

Herbal Medicine- Subsequent Visit
File Size: 167 kb
File Type: pdf
Download File


Massage Therapy


When you book your Massage Therapy visit, an online intake form will be emailed to you. 

ltc_test.pdf
File Size: 100 kb
File Type: pdf
Download File

Athletic Therapy



Picture

250-590-2501
​
info@mandalahealthcenter.com



  • Welcome
    • Covid 19 clinic safety plan
    • Testimonials
  • Book Online
  • Who We Are
    • Acupuncturists >
      • Dallas Nye
      • Jacqueline Rioux
      • Lori Race
    • Massage Therapists >
      • Caitlin Sartorio
      • Cara Legacy
      • Carly Britton
      • Emiko Ihara
      • Meghan Kelly
      • Nicole Baker
      • Steve Ferris
    • Counsellors >
      • MXN Mens Therapy Network
      • Shirley Graham
  • What we do
    • Acupuncture >
      • Pain Conditions & Injuries
      • Women's Health, Fertility & Pregnancy
      • Cosmetic Acupuncture
    • Hypnotherapy
    • Clinical Counselling
    • Massage Therapy
  • Rates
  • Insurance FAQ
  • Connect With Us
  • Career opportunities