Register as a New Patient

The Health Clinic by ShoppersTM is accepting new patients. Please fill out this form with your personal information and a member of our team will contact you to review your request and begin the enrolment process. Please note that physician availability to accept new patients may vary.

* Required information

This field is required name
This field is required email
Invalid Phone Format
Select a service*
Select a city*
Select a location*
choose one