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TEAM
- Family Doctors & Specialists
- Wellness Practitioners
PARTNERS
ANNOUNCEMENTS
PATIENT HELP

Use tab to navigate through the menu items.

Book an Appointment

Make a Payment

Annual Block Fee Registration Form

Section 1: Block Fee Selection

Please select an option:

Block Fee Plan*

Individual Block Fee (1 Person)

Individual Block Fee (1 Person)CA$120

Family Block Fee (up to 6 people)

Family Block Fee (up to 6 people)CA$210

** All members covered under a family plan must reside at the same address.

Payment Form

Use this form to submit a payment to the clinic. Once filled out, you will be directed to the payment page to complete the transaction.

If the payment is for more than one patient, please mention this in the 'Additional Information' section.

Patient First Name*

Patient Last Name*

Email*

Phone*

Please enter the amount you are paying:

Medical Expense*

CA$

Additional Information

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