Patient Detail

Identification

Please complete the following form for the person with a healthcare need.

All the fields are mandatory.

Family name

Error: Last name is required

Given name

Error: First name is required

Phone number

Enter a number with a valid area code

Please verify your area code.

Health insurance number

Error: The health insurance number must follow this format: YYYY 1111 1111.

Sequential number

Error: The sequential number must follow this format: 01.

Date of birth

Day

Month

Year

Error: The date of birth format must be greater than 0 years.

Genre

Postal Code

Please enter the postal code
of your home or current location.

How are available appointments displayed?

Step 1.

Availabilities in your clinic

We look for an appointment in your clinic, preferably with your healthcare professional. If that isn’t possible, we check with another professional at your clinic.

Step 2.

Openings in clinics near your postal code

We check whether an appointment is available in clinics near your home (based on the postal code provided).

How are available appointments displayed?

Communication Method

Appointment reminders are sent by email when an address is provided. Text message notifications are not available currently. You can always view or cancel your appointment in the “Appointments made” section.

Preferences

Select the period(s) of the day and the maximum distance. The search results will be based on availability. We cannot guarantee we will meet your exact choices.

Error: Please review your information.

I have a healthcare need

Identification

Communication Method

Preferences