New Patients

New Patient Registration

Welcome to Riverview Medical Centre. Please complete the form below to register as a new patient. This form is separate from booking an appointment.

Submitting a registration request does not guarantee acceptance as a patient of the clinic.

Do not submit urgent medical concerns through this form. For emergencies call 911.

This website is for appointment requests and clinic information only. Medical advice is not provided through this website.

Please do not submit highly sensitive medical information through online forms. Clinic staff may contact you for additional information if required.

Full name*Date of birth*Phone number*Email*Address*Province*Insurer*Alberta Health Care number (optional)Preferred family doctorPreferred language (optional)

Additional notes (optional — non-urgent only)

This website is for appointment requests and clinic information only. Please do not submit highly sensitive medical information through this form. Clinic staff may contact you for more information if required.

I consent to Riverview Medical Centre collecting and using the information above to process my registration request and to contact me regarding my care.