Headache Intake Form

We are using a headache intake form to ensure we have all the necessary information in order to help you manage your headaches. You can fax, mail or email this form to us. We do not recommend regular email as it is not secure. There are a number of free secure file sharing applications available such as https://www.securedocs.ca/ . Alternatively, you can send us a simple email saying you'd like to securely send us an email, and we will reply in the encrypted email format which you can then attach your completed document.