New patients
One registration request for you—or your household.
Prepare the information below before you begin. The form supports additional family members while keeping everyone attached to one household request.
Have these ready
The form takes a few careful minutes.
For privacy, health card numbers are cleared if the server asks you to correct another field.
- 01
Contact details
Name, date of birth, email, phone number, and preferred contact method.
- 02
Health card
The 10-digit number and one- or two-letter version code.
- 03
Home address
Current street address, city, province, and postal code.
- 04
Family members, if needed
The same core details for each person added to the household request.
Important
A registration is not an acceptance confirmation.
Clinic staff must review the request and contact you about next steps. Submission does not guarantee intake, a physician assignment, or a response time.