New-patient registration
Register your child in five short steps
About four minutes. Our front desk calls you within one business day to book the first visit. This form is for registering, not for medical questions or urgent concerns.
If this is an emergency, call 911 now. For urgent worries, call the 24/7 nurse line at (613) 555-0199. This form is for registering only and is not checked after hours.
New-patient registration
Step 1 of 5: Your child
Demo form: nothing you enter is sent or stored. Fields marked optional can be left blank.
- Your child
- Parent or guardian
- Health coverage
- First visit
- Review
Registration received (demo only)
This is a demo, so nothing was sent and nothing was stored. On a live site, our front desk would call you within one business day to book the first visit at your chosen clinic.
After you register
What happens next
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1. We call you back
Our front desk calls within one business day to book the first visit at the clinic you chose.
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2. Records follow you
Tell us your previous clinic and we request the records directly. You don't chase anything.
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3. The first visit
Booked long on purpose, with time for history, an exam and every question on your list.
Rather do this by phone?
Call either clinic during opening hours and our front desk will take the same details with you, usually in under ten minutes.