Birchwood Medical Clinic

REGISTER FOR A FAMILY DOCTOR

Please submit your contact information and a member of our staff will contact you to confirm your spot with one of our doctors accepting new patients.

First Name *

Last Name *

Email *

Phone *

Date of birth *

Ontario Health Card Number *

Address

Street Address *

City

State

Country

Postal code

By providing my contact information, I agree to be contacted by phone, text, or email.*

Contact

[email protected]

416-800-6949

FAX: 866-973-8509