Leave a Review

For Your First Visit

adult intake form

Adult Intake Form

Age 14 +

Fill Out Form

child intake form

Child Intake Form

Age 5 - 13

Fill Out Form

infant intake form

Infant Intake Form

Age 0 - 4

Fill Out Form

Goal

Our goal at Tillsonburg Chiropractic and Wellness Clinic is to eliminate every bit of apprehension you may have visiting a chiropractor for the first time.

Since chiropractic care involves a series of visits, each one building on the one before, it’s important that our relationship can go the distance. One of the best ways to have successful patient relationships is to explain everything in advance. The more you understand who Dr. Fatima Manji (Korah) is and what she does, and why she does it, the better results you’ll enjoy.

Remember . . .
If you have x-ray reports or MRI/CT reports, please bring them along. Depending on the results of these preliminary tests, Dr. Manji (Korah) may recommend x-rays be taken.

Please plan on approximately one hour for your first visit.