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Congratulations on booking your Foundational Health Consultation!

This is the first step to improving your health and well-being!

Please fill in the initial intake forms (for you or your child) prior to the first visit.  

Just click on the corresponding PDF button and the forms will download immediately onto your computer.


You can fill in your information by:

  • Printing the forms, filling it in manually and bringing to your visit


  • Using Acrobate Reader Tools (Fill and Sign) to complete the form and email before the visit

I am located at 141 Wellington street, unit 3. It is a large yellow brick office building.  Please feel free to park in the parking lot behind the building, and walk up the ramp at the side of the building and come in.  My office is through the hallway, turn right and head towards the front door. I'm the second office on the left. Please come into the waiting area and grab a seat and I will call you in when I am ready. Please note, I ask that all patients remove their shoes prior to coming into my office and that my office is a scent free environment. If you have any questions prior to your visit please feel free to email me at

I look forward to working with you!


In Health,

Dr. Michelle

Initial Intake Forms

Adult Intake Form

Age 19 and over

Adolescent Intake Form

Age 10 -18 years old

Child Intake Form

Birth to Age 9 years old


From London:

Follow Wellington Road south into St. Thomas and at the roundabout at sunset drive, take talbot hill (talbot street) to the top of the hill and turn right at Stanley street.  Turn left at the stop sign onto Wellington Street, take wellington to 141 Wellington street, and take the second driveway and park behind the building. If you hit Ross street you have gone to far.

From Aylmer:

Take Talbot Street all the way into St. Thomas and turn left at Ross street. Follow Ross Street to Wellington street and turn Right. Take a right turn into 141 Wellington street, and take the first driveway and park behind the building.

From Port Stanley:

Take Sunset Drive into St. Thomas, turn right onto Elm Street. Turn left on Wilson Ave, and take Wilson to Wellington street. Turn right onto Wellington street, and follow to 141 Wellington street, and turn left into the second driveway and park behind the building

Trillium Health Clinic
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Book a Meet & Greet or Foundational Health Consult

Phone: (519) 854-3824

Naturopathic Medicine and Wellness

Dr. Michelle Myszko, ND

New Location: 141 Wellington Street, Unit 3, St. Thomas, ON, N5R 2R8

Phone: (519) 854 - 3824

Trillium Health Clinic

Dr. Michelle Myszko ND
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