BURLINGTON SOUTH - REGISTER FOR A DOCTOR

Burlington (South)

Please fill out the following form to register for a doctor in the Burlington South Area. You are able to use this form to register yourself, your spouse and your children, as well as select other medical services that we provide.
Someone will be in contact with you shortly.

Your Information

Language, Who is Registering and Doctor Info

Other Services of Interest

Naturopathic Doctor
Ohip Funded Medical Weight Management
Diabetes Clinic
Physiotherapy
Dental
Travel Clinic
Massage

Additional Comments

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* A Health card number must be provided when the staff calls.

Please press submit only once and wait for the reply on screen.


If you have any issues with this form, please try a different browser or a different internet connection. We get many submissions daily, so most issues are client computer related (Firewall etc). If you still have any issues after trying a few different browsers/computers, please email webmaster@registerforadoctor.com and let us know the specifics so that we may fix your issue.