Patient Registration
Patient Registration Information
Welcome to our clinic! We’re dedicated to providing you with comprehensive healthcare services in a comfortable and caring environment. To join our clinic and access personalized care, please complete our patient registration process. This will help us better understand your medical needs and ensure that your records are accurately maintained.
Registration Process: To register as a patient at our clinic, you’ll need to fill out the registration form which includes providing some essential information about yourself. This will help us serve you better and more efficiently.
What You’ll Need to Provide:
- First and Last Name: To properly identify your medical records.
- Health Card Number: Necessary for processing your health services.
- Date of Birth: Helps in verifying your identity and for any age-related medical checks.
- Address: To have contact details for any communications or in case of emergencies.
- Email: For sending medical updates, appointment reminders, and digital communication.
- Phone Number: For appointment confirmations or urgent communications.
- Doctor Selection: We have a team of qualified doctors you can choose from based on your health needs or preferences.
Additional Information You May Provide:
- Emergency Contact Details: It’s important to have an emergency contact on file.
- Medical History Overview: Any key past medical history, ongoing treatments or medications you are taking.
- Insurance Information: If applicable, for billing purposes.
Privacy and Confidentiality: Your information is kept confidential and is used strictly for medical purposes as per our privacy policy. We adhere to the highest standards of patient data protection.
PDF Registration Form: A PDF version of the patient registration form can be created to facilitate the entry of the information listed above. This form can be downloaded from our website, filled out at your convenience, and submitted electronically or in person at our clinic.
If you’re ready to proceed with your registration, please visit our website to download the registration form or visit our clinic to complete the form in person. We look forward to providing you with quality healthcare.