Dr. Katrin

please email us to receive your health intake form.

our office is located at:
Katrin Schubert (Bergstrome) acupuncture, holistic medicine and BodyTalk:

4 Cataraqui street, Kingston, Ontario K7K 1Z7 (613)541-1144

226 South Street, Gananoque, ONtario K7G 1A3 (613)382-7686

When filling it out, if possible, please use a blue or green pen as it makes reading it much easier. Thank you!
You are welcome to leave boxes blank if they do not apply to you.
Make sure you bring it into the office with you.