If you have a preference as to which Family Doctor you would like to register with, please indicate your choice here.
I have read and agree to the Clinic Policies (available on our "About Us" page ). I certify all information provided to WellOne Medical Centre to be true and acknowledge that by clicking this box that I have given consent to release this information to be used in the clinic only and will not be shared externally. I agree to Magenta Health Inc. contacting me by email. IF THIS IS A MEDICAL EMERGENCY, PLEASE CALL YOUR LOCAL EMERGENCY SERVICE (911) TO GET PROMPT MEDICAL ATTENTION. DO NOT RELY ON ELECTRONIC COMMUNICATIONS FOR ASSISTANCE REGARDING YOUR IMMEDIATE, URGENT MEDICAL NEEDS. THIS FORM IS NOT DESIGNED TO FACILITATE MEDICAL EMERGENCIES