Initial Intake Form -

Initial Intake Form (Confidential) download

Select the Word or Page version, download, fill out and email me before your first consultation.

Word Format

Please take the time to fill out the form and email it back to me for consultation day, at the latest. Thank you

PagesFormat for MAC

Please take the time to fill out the intake form and email it back to me for consultation at the latest. Thank you

To book an appointment
Contact: ingrid@Homeopathe.ca

Ingrid Schutt :

514- 991-6316

604-728-2290

Bring or send me a copy of your child’s vaccination card if your child was vaccinated.