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NEW PATIENT REGISTRATION
webmaster
2025-11-17T16:24:28+00:00
First Name
*
First Name as on your health card
Last Name
*
Last Name as on your health card
OHIP CARD #
*
Version Code
*
Email address
*
Phone Number
*
Desired Appointment Day (Appointment Time to Be Confirmed)
Tuesday 9-4
Wednesday 9-4
Thursday 10-6
Saturday 8-12
Desired Appointment Time
We will email you to confirm Date and Time
SUBMIT
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