Register as a New Patient

Have questions first? Call us at (416) 609-1100.

This form is for new patients only. If you are already a patient with us, please book online instead.

Refugee patients with Interim Federal Health Program (Blue Cross) coverage are welcome to register.

Your Details

Please enter your name exactly as it appears on your health card or immigration documents. Fields marked with * are required.

Website

Clinic Location * Select… North York (Unit 201, 1252 Lawrence Avenue East)East York (45 Overlea Blvd, Suite B6)

First Name *

Last Name *

Cell Phone *

The number our team will call about your registration.

Email *

Date of Birth *

Gender (optional) Select… Female Male X Prefer not to say

Identification Type * Health Card Number UCI Number (Immigration) Uninsured Patient

Health Card Number *

Please include the version code (the letters after the number).

Anything you'd like us to know? (optional)

No need to include your full medical history. Our team will go over the details by phone.

Submitting a request does not guarantee acceptance as a patient or placement with a specific physician. We match new patients based on availability.

Register

Your information is submitted securely and used only to process your request.