Schedule Now

 

Patient Intake Forms

Download, print and fill out our paperwork in the comfort of your home.

Click the download button below to download our paperwork as a PDF Document and simply bring them with you to your next visit with Dr. Schirru.

Required

Adobe Reader Required

In order to view and print our intake forms you must have Adode Reader. If you don't have Adobe Reader you can click the "Get Adobe Reader Button" to download and install it from the official adobe website.

It's free, safe, and takes less than 2 minutes.

Have A Question About Being a New Patient? 519-451-5919

  • Intake Forms

    Download and Print our intake forms.

  • My First Visit

    What to expect at your first visit.

  • Payment Options

    Affordable care for everyone.

  • Gallery

    Photos of Inner Balance Chiropractic & Massage Therapy Centre

Autumn Dittrich-Griffith

Life changing for my minor brain injury issues. When I first walked into Dr. Schirru’s chiropractic office last week I had taken a fall the night prior in the shower and hit my head once again. I have been suffering for 6 months with post major concussion symptoms also referred to as a minor brain injury. 24 Hour pain and pressure behind my left ear, Vertigo, memory intake issues, limited sleep, my mind always feeling foggy, severe Tinnitus and tracking issues in my left eye. I had reached a point where I was taking large amounts of nerve blockers for the pain, sleeping 3-4 hours a day due to pain exhaustion and wearing a 10lbs weight vest so I could actually walk in a straight line. I walked into Inner Balance believing I would have an adjustment completed on my neck from the pain I had endured from the prior nights shower fall. My appointment went differently then I could have ever imagined. Dr. Schirru took the time to Listen not just regarding my shower fall aches but to everything I had experienced in the last 6 months. Dr. Schirru examined my x-rays his office had completed and well…. the results of Dr Schirru’s adjustments have left me knowing things are truly going to be ok. Within my first 2 adjustments 100% of the pain and pressure behind my left ear was gone; I am already off 100% off the nerve block medicine. My vertigo 100% gone; balance is back. I have stopped wearing my 10lbs weight vest. My thought process is starting to feel crisp again. My memory intake is improving. My severe Tinnitus is not that “ severe” anymore. I’m not sleeping 3-4 hours a day due to pain exhaustion. I feel that Dr. Schirru gave me my life back in only the first few visits. I will continue on with the 5 stages of care. I share this hoping it reaches just 1 person with a minor brain injury to know there’s a solution.

Jared Gilbert

I've been going to inner balance for my whole life and I believe it has given me alot of energy and I've not had health problems.

Brenda Dottermann

Dr Schirru is really personable, the front counter staff are friendly and Dani the RMT has the best hands! Professional environment and people all around.

Max Valkenier

Since I started visiting Inner Balance Chiropractic 2 years ago I have had great positive effects on my body. I have sciatic nerve issues that is slowing me down and have an appointment with a specialist in 2014. In the mean time I get adjustments to alleviate the pain for as long as I can. I truly look forward to my visits, the staff in the office are warm and friendly professionals, and Dr. Schruu is definitely the professional that he claims to be. Thank you for keeping me healthy.

© 2019 ChiroBuilt. All Rights Reserved.