Your first visit

UPDATE: February 26, 2025
 
We are welcoming new patients!
Please note that the following providers are currently accepting new patients.
 
Lonsdale Location:
Vesna Papuga, NP
 
Marine Drive Location:
 
Please, complete our New Patient intake form online. Our office will be in touch with you.
 
Expect to hear from us within few weeks. Applications are prioritized based on complexity.
Please note that filling out an application does not guarantee that you will be contacted or accepted.
 
Our physiotherapist Shirin Hatami is accepting New Patients. Please see online booking for her availability and her scheduling. Once booked, please complete the Physiotherapy Intake form online.
Our podiatrist is accepting New Patients as well. Check the link for more information.
 
New patient intake form

    *Please complete ALL sections as wait-list requests are prioritized on a complexity basis.

    Patient Information:

    Gender

    MaleFemaleOther

    Medical History*:

    Do you have any of the following conditions?


    Acid Reflux


    AIDS/HIV


    Anxiety


    Arthritis Osteo/Rheumatoid


    Back pain


    Bleeding disorders


    Blood clot


    Cancer


    Cholesterol


    Circulation


    Diabetes (Type 1/2)


    Fibromyalgia


    Gout


    Heart Attack


    Heart disease


    Hepatitis A / B / C


    Hernia


    High blood pressure


    Kidney problems


    Liver problems


    Lung problems


    Lupus


    Mental Health


    Migraines


    Osteoporosis


    Prostate


    Psoriasis


    Stroke


    Thyroid


    Tuberculosis


    Other

    List of current medications*:

    Do you have any of the following?


    Active WCB case


    Active ICBC case

    Please rate by degree the level of use of the following:

    Alcohol:


    RegularOccasionalNever

    Drugs/ substances:


    RegularOccasionalNever

    Cigarettes:


    RegularOccasionalNever

    Names of any current specialists involved in your care*:

    List any past hospitalizations / surgeries*:

    Please state your preference:


    First available Provider


    Preferred Provider (name)