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Patient Information

First name

Last name

Phone Number

REASON FOR MESSAGE:

If none of the below are applicable, please phone the clinic. *Your request will not receive a response if not applicable to the options below.*

If you need a medication renewal, please book an appointment. Otherwise, you can ask your pharmacy to send us a renewal request that will incur a fee of $30.

To cancel an appointment, please go to our website and click "CANCEL APPOINTMENT".

Insurance Note Request (Physio, RMT, Chiro, Orthotics, ect.)

Please note this service is not covered by OHIP. You may also be asked to book an appointment.

Inquiring About Results

Please first visit https://www.thechristieclinic.ca/about-3 to see how you can view your results online. Please note that if you are requesting a copy of your results to be sent to you, this will incur a $10 administrative fee per report.

Insurance Note Request

Please include reason for your Insurance note and what services are needed (ie. RMT, Physio, Naturopath ect.) Any other forms that need completion, please book an appointment.

Files

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Inquiring About Results

Please list the test (blood work, x-ray, ultrasound) and when/where it was performed. You will either be notified of results by phone, email, or will be booked in with your physician to review.

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