New Patient Application (March 2023)

If you would like to be added to our patient wait list, please complete the form below. Please submit only one application per household/family.

Applications will be retained and reviewed as patient capacity becomes available, including when new physicians join our clinic.

When patient spaces become available, the clinic may consider community healthcare needs and access to primary care when reviewing applications.

We will contact applicants if there is a change in patient capacity or if additional information is required.

Please consider becoming a member of the Community Health Association (Regina) Limited. Membership allows you to receive clinic news, updates, and correspondence. Membership is not required to apply for the patient wait list and does not influence your eligibility or priority for becoming a patient.

• Co-operative members of the clinic must be 18 years of age or older.

Thank you for your submission.