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Virtual Health Services
Contact Preference
Location Information
Appointment Options
Time Of Day Available
Date Of Availability
Virtual Health Services
Do You Have A Valid Health Card?
YES
NO
Select A Virtual Health Service?
*
Please Choose A Service..
Online Walk-In
Cannabis
Coronavirus
Sick / Infections / Injuries
Mental Health, Counselling & Wellness
Naturopathic Medicine
Chronic Conditions
Prescriptions
Referrals & Medical Notes
Requisitions, Testing & Reviews
Skin Issues
Travel Health
Veterinarian
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Contact Preference
What Is Your Perferred Point Of Contact?
PHONE
SMS
EMAIL
What Is Your Phone Number?
*
What Is Your Email?
*
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Location Information
Choose The Province You Live In?
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Appointment Options
Who Is This Plan Primarily For?
MYSELF
SOMEONE ELSE
BUSINESS
First Name
*
Last Name
*
Number Of Family Members
*
--Please choose an option--
0
1
2
3
4
5
6+
Number Of Employees
*
--Please choose an option--
1 to 5
6 to 19
20 to 49
50 to 199
200 to 499
500 to 999
1000+
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Time Of Day Available
Best Time To Be Contacted?
Morning
(7am-12pm)
Midday
(12pm-5pm)
Evening
(5pm-10pm)
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Date Of Availability
What Days Of The Week Are You Available?
Monday
Tuesday
Wednesday
Thursday
Friday
Saterday
Sunday
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