
The first step in booking an appointment is completing the Intake and Service Option Form, which provides me with basic information about you and the nutrition support you are seeking, so I can prepare for your appointment.
NOTE: As outlined on the individual service pages, please select the Initial Consultation when completing the Intake and Service Option Form for hEDS, MCAS, or POTS, a 3:1 therapeutic ketogenic diet, or a 2:1 therapeutic ketogenic diet.
Getting Started is as easy as 1-2-3
Data sent through our web page forms are encrypted end-to-end using TLS 1.2 or higher with 256-bit encryption. We are PIPEDA-compliant to meet Canadian privacy requirements under the Personal Information Protection and Electronic Documents (PIPEDA) Act.
You only need to complete 3 pages: the first two and the last. The remaining pages list available services to choose from.
- All boxes on the form must be completed.
- Please keep your answers within the box capacity, as excess text will be truncated.
- Remember to check off the service(s) you are requesting.
Click here for step-by-step instructions for downloading a PDF lab report summary from BC, AB, or ON.
Short on time now? Both options below provide a link so you can email the form to yourself and complete it later.
Holiday Closure: We will be closed for the holidays from Monday, December 21, 2026, to Friday, January 1, 2027, inclusive. Regular appointments will resume after the holidays.
Complete the Intake and Service Option Form
Need more room than the boxes hold? Read here:
Since excess text beyond the box capacity will be truncated, those with complex clinical needs may need more room to list diagnoses, medications, or medical details. In such cases, (1) please write “see Additional Health Information Form” in the box on the form that is too small, finish completing the form, and submit it, then (2) complete the “Additional Health Information Form” by clicking here.
OPTION B: Book via Email or Fax
Download and Complete the Intake and Service Option Form Manually
Click Here to Download Form & Step-by-Step Instructions
1. Download the Form
Download the Intake and Service Option Form (dated June 1, 2026) to your computer.
NOTE: All boxes on the form need to be completed because we need this information to understand your needs and set up an appointment. For this reason, incomplete forms will be returned.
Please avoid using ALL CAPS when completing this form.
✉️ On your phone? Email this PDF link to yourself to open later on your computer
If you want a password-protected form, please send us a note through the Contact Us form, and we will send one.
2. Complete the Form
The Intake and Service Option Form must be completed on a computer, tablet, or smartphone. For a Windows device, use the free Adobe Online tool, or for a Mac device, use Preview.
If you need help, there are Step-by-Step Instructions here.
NOTE: Please do not exceed the box capacity on the form, as it becomes unreadable. For boxes that need more space, download the “Additional Health Information Form” to your computer, complete the fields that need more space, and send it with your other documents.
3. Email or Fax Your Documents
Email your completed Intake and Service Option Form to the address on the first page of the form, or request our fax number.
- Please do not scan the form before sending it, as it is needed ‘as is’ for our charting and accounting system.
Please feel free to redact your healthcare number on lab work before sending, or to fax the documents directly to our office.
NOTE: If sending Intake and Service Option Forms for more than one person, please send them in separate emails, with the relevant attachments.
Note: If you are a Healthcare Provider looking to refer a patient or a Rehabilitation Consultant, please visit the FAQ page.
