Buying a Chiropractic Clinic in Ontario: Ownership, Records, Prepaid Plans and X-Ray Registration

By Jatin Dua · Broker of Record, RE/MAX Quantum Realty · Updated 29 September 2026 · 12 min read — what the College of Chiropractors of Ontario and the X-ray law mean for a buyer, and the records I would want before any offer.

What you are really buying

A chiropractic clinic’s value sits in active patients, the chiropractors who treat them, the front desk that books them, the treatment rooms, any X-ray equipment and the lease. Take out the treating chiropractors and most of the value walks with them, so the first question is always who stays.

No regulator, government body or real estate board in Canada publishes sale prices or valuation multiples for these practices. Anyone quoting you “the multiple” is quoting a private opinion. Price the business from its own records instead, and make the seller produce them.

Many clinics also offer physiotherapy, massage or other services. If so, each profession brings its own College rules; see buying a physiotherapy clinic in Ontario and buying a massage therapy clinic in Ontario.

Who may own a chiropractic clinic

The College of Chiropractors of Ontario (CCO) regulates its members. Its standard S-022, in effect since 24 February 2023, says: “There may be circumstances where a member practises in a group setting where the owner of the clinic is not a member of CCO or not a member of an Ontario regulated health profession.” It adds that CCO has no jurisdiction over people who are not its members, and that the chiropractor practising in such a setting must still comply with privacy law and the standards of practice.

So a non-chiropractor can own the clinic business, but the chiropractors working there remain accountable to CCO, and your agreements with them must let them meet their obligations.

A chiropractic professional corporation is narrower. Under the Business Corporations Act, s. 3.2, all shares of a health profession corporation must be owned by members of the same profession, and all officers and directors must be shareholders. CCO charges $52 to apply for a certificate of authorization, $625 on issuance and $210 a year to renew. If the seller operates through one, you can only buy its shares if you are eligible to hold them; otherwise you buy the assets.

Patient records and who holds them

CCO standard S-002 requires records to be kept at least seven years after the patient’s last visit, or for a minor, seven years after the day they turned or would have turned 18. When a chiropractor leaves, the record is to go to another member with reasonable efforts to get the patient’s consent, and the patient is to be told.

S-022 says the health information custodian “may be an individual member, a group of members, a chiropractic health corporation or the facility from where the member practises”, and that no agreement dividing records on a break-up may stop a patient from getting their record. Under PHIPA, when complete custody or control of records passes to a successor, the successor becomes the custodian, and the seller must make reasonable efforts to notify patients.

Before an offer, find out who the custodian actually is today. If each chiropractor is their own custodian, you may be buying a clinic whose records do not belong to the seller to transfer.

Prepaid treatment plans are a liability

Many clinics sell care plans or blocks of visits in advance. CCO’s guideline G-008, in effect since 24 November 2022, says any such arrangement needs a written agreement, the patient must be offered a pay-per-visit option with the regular unit cost disclosed, and the chiropractor must fully refund any unused portion within 30 days of the patient’s request.

For a buyer, that is cash the seller has already collected for treatment you will deliver. Ask for a list of every open plan with the unused balance, and have your lawyer deal with it in the price or the closing adjustments. The same goes for gift certificates.

X-ray equipment has to be registered to the new owner

Under the Healing Arts Radiation Protection Act, s. 4(1), the owner of an X-ray machine may not operate it on people unless the machine, its location and the owner’s name and business address are registered with the Director. Section 3 says no one may install an X-ray machine without the Director’s written approval, and changing an installation counts as installing. A registered owner who changes business address or email must tell the Director in writing within 15 days.

In a sale, that means the new owner’s registration must be in place before the machine is used, and moving the machine to another room or another location needs approval first. Ask for the current registration, approval documents and service records.

Asset or share purchase, HST and staff

Chiropractic services rendered by a practitioner are exempt from HST under Excise Tax Act Schedule V, Part II, s. 7(b). Products, and services the clinic sells that are not on the exempt list, can be taxable. On the sale itself, s. 167 lets a seller and a buyer that acquires all or substantially all of the assets needed to run the business jointly elect so no tax is payable on those assets, on CRA form GST44. The election is not available where the seller is a registrant and the buyer is not. Let your accountant decide whether it applies.

Under the Employment Standards Act, s. 9, employees you keep carry their service with the seller over to you, unless you hire them more than 13 weeks after the earlier of their last day with the seller and the sale date. Associate chiropractors are often independent contractors, not employees; read every associate agreement for notice terms and what happens to their patients if they leave. Section 67.2 generally voids non-compete agreements with employees, with an exception for a seller who becomes the buyer’s employee immediately after a sale.

Documents I would want before an offer

1. Three years of financial statements, tax returns and HST returns.
2. Revenue by practitioner and by service line, with new-patient and active-patient counts on a written definition.
3. Every associate and staff agreement, with start dates, pay and notice terms.
4. A list of open prepaid plans and gift certificates with balances.
5. X-ray registration, installation approval and service records.
6. An equipment list with age and condition.
7. A written statement of who is the health information custodian today.
8. The lease, amendments and the landlord’s assignment conditions.
9. CCO registration status for every chiropractor, checked on the public register.

The premises

Zoning, the Building Code, the X-ray room’s shielding and the lease all shape what you are buying. I cover them in chiropractic clinic space in Ontario. If you are comparing this with an eye-care purchase, see buying an optometry practice in Ontario.

Where I fit

I work with buyers and sellers of clinics across Toronto and the GTA on the real estate side: the lease, the assignment, the space and sometimes the building. The office space value estimator below gives a quick range for clinic space. When you are ready to look at a clinic, book a call or phone 833-330-1925.

Frequently asked questions

Sources

• College of Chiropractors of Ontario — Standards of practice
• College of Chiropractors of Ontario — S-022 Ownership, storage, security and destruction of records — clinics owned by non-members; custodians
• College of Chiropractors of Ontario — S-002 Record keeping — seven-year retention
• College of Chiropractors of Ontario — G-008 Business practices — prepaid plans and 30-day refunds
• College of Chiropractors of Ontario — Incorporation — certificate of authorization fees
• CMTO — Guide to a Certificate of Authorization (quotes OBCA s. 3.2) — professional corporation share ownership rules
• Information and Privacy Commissioner of Ontario — PHIPA FAQ — transfer of records to a successor
• Healing Arts Radiation Protection Act — e-Laws — X-ray installation approval and registration
• Excise Tax Act, Schedules V and VI — Justice Laws Website — exempt practitioner services, cosmetic service supplies, prescription eyewear
• Excise Tax Act, section 167 — Justice Laws Website — joint election on the sale of a business
• Employment Standards Act, 2000 — e-Laws — s. 9 sale of a business; s. 67.2 non-compete agreements

Related reading

• Chiropractic clinic space in Ontario
• Buying a massage therapy clinic in Ontario
• Buying an optometry practice in Ontario
• Buying a physiotherapy clinic in Ontario
• Physiotherapy clinic space in Ontario
• AI office space value estimator
• Book a call with Jatin