Register For Family Doctor

Register for a Family Doctor

Please fill out the following form to register for a doctor at Halton Family Health Centre. You are able to use this form to register yourself, your spouse and your children, as well as select other medical services that Halton Family Health Centre provides. Someone will be in contact with you within 7 - 10 days.

Please Enter your Name the same way that it appears on your Health Card

What kind of Doctor would you prefer

No Preference
Male Physician
Female Physician
No Preference
Male Physician
Female Physician

What Other Services Would You Like to Hear From

Naturopathic Doctors
Physiotherapy
Chiropractor
Dental
optometry
Hearing Specialist‎‎
* A Health card number must be provided when the staff calls.