We are not accepting new patients at this time.

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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.

Full LEGAL Name (First and Last) *

Phone Number (000-000-0000) *

E-mail

Do you currently have a family physician? *

-- Do you currently have a family physician? -- YES, I currently have a family physician NO, I do not have a family physician

If YES, please indicate your reason(s) for wishing to change from your current physician to one at the Regina Community Clinic

Are you a sole applicant? *

-- Are you a sole applicant? -- YES, am I a sole applicant NO, I am not a sole applicant

If NO, please list all family members and their relationship to you. Please list full LEGAL names (first and last)

Are you an immediate family member of RCC staff? *

-- Are you an immediate family member of RCC staff? -- YES, I'm an immediate family member of RCC staff NO, I'm not an immediate family member of RCC staff

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We cannot guarantee the opportunity for additional patient capacity; however, we are recording the number of individuals who require a physician and who wish to become a patient of our clinic.

It is important to seek medical services elsewhere. It is highly unlikely we can extend our patient capacity within the next 12 months.

If you wish to be notified of any updates and clinic news, please consider taking a membership. Please see the link in solid green below. 

  More on Becoming a Member of the Regina Community Clinic