Get New Patient Information Sheet

Completing the New Patient Information Sheet online is a straightforward process that ensures your information is accurately captured before your visit. This guide will lead you through each section of the form, allowing you to provide essential details with ease.

Follow the steps to complete the New Patient Information Sheet online.

1. Click ‘Get Form’ button to access the New Patient Information Sheet and open it in your preferred editing tool.
2. Begin by filling in your last name and first name in the designated fields. This information is critical for identifying your records accurately.
3. Next, enter your date of birth, ensuring to use the correct format (DD MM YEAR). This helps establish your age and certain eligibility criteria.
4. Indicate your gender by selecting either M or F. This information may be relevant to your healthcare needs.
5. Provide your occupation in the corresponding field. This could assist in understanding certain health contexts.
6. Fill in your street address, including any unit or apartment number, city, province, and postal code. Accurate address details ensure proper communication.
7. Record your contact numbers, including home, work, and cell, highlighting the best number to reach you.
8. Include your email address for any digital correspondence we may need to send you.
9. Write the name and telephone number of your emergency contact. This is critical information for ensuring your safety.
10. List your family doctor’s name, address, and phone number, which can facilitate necessary medical follow-ups.
11. Indicate how you learned about our clinic by circling one of the provided options. This helps us improve our outreach efforts.
12. Provide the name of your insurance company, if applicable, to aid in billing and coverage inquiries.
13. Describe the service you are seeking today to allow us to prepare adequately for your visit.
14. Review the various services and products offered and check any that may interest you. This could help us address all your needs during the appointment.
15. Once all fields are completed, ensure to save your changes. You may download, print, or share the form as necessary.

Complete your New Patient Information Sheet online today for a smooth and efficient visit.