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Brussels Osteopath
New Patient Intake
🇫🇷 FR

Before your first visit

A quick form to help us prepare for your appointment.

Under 2 minutes
1
Your Visit
2
Consent
About you & your visit
Basic details and why you're coming in.

0 = No pain10 = Worst imaginable

Currently pregnant?
Taking blood thinners (anticoagulants)?
Any serious medical condition or recent surgery?
Consent & GDPR
Please read and confirm before we proceed.

Thank you — all done.

Your form has been received. We'll review it before your appointment and see you soon at the practice.

Step 1 of 2