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                  <h1>Initial Intake Form</h1>
                  <h4>Alliston Physiotherapy + Sports Rehab</h4>
                  <p>The information request below will assist us in treating you safely. Feel free to ask any questions about
                    the information being requested. Please note that all information provided below will be kept
                    confidentially unless allowed or required by law. Your written permission will be required to release
                    any information. </p>
                </center>
                [shortcode_form name="_new-patient-form" route="web.new-patient.save"]
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