New Patient Registration

Welcome to Seaway Valley Medical Centre. Please complete all required fields to begin your registration.

Registration is available online and in-person only. No phone calls please.. Our team will contact you if your application is accepted.

Patient Information

First Name

Last Name

Phone

Date of Birth

Health Card Number

Version Code

Patient Address

Street Address

Address Line 2

City

Province

ZIP / Postal Code

Preferred Pharmacy

Preferred Pharmacy Address

Additional Information

Message (Optional)

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