Forms

For all form completions, please drop off at reception or fax to 613-258-6171.  Please note patient information and signature must be completed prior to submitting your forms.  All forms that are brought into a scheduled appointment will not be completed same day.  Physicians have 45 days to complete any forms. Fees may apply.

First Visit Form

New Patient Medical History Form: http://www.rideaucrossingfhc.ca/sample2/wordpress/wp-content/uploads/2024/03/NEW-PATIENT-MEDICAL-HISTORY-FORM.odt

Consent Forms

Consent to Disclose: http://www.rideaucrossingfhc.ca/sample2/wordpress/wp-content/uploads/2024/03/2024-Consent-to-Disclose.pdf

Consent to Obtain: http://www.rideaucrossingfhc.ca/sample2/wordpress/wp-content/uploads/2024/03/2024-Consent-to-Obtain.pdf

Chart Transfer Consent: http://www.rideaucrossingfhc.ca/sample2/wordpress/wp-content/uploads/2024/03/2024-Chart-Transfer-Consent.pdf

Welcome Packages

Solo Practice: http://www.rideaucrossingfhc.ca/sample2/wordpress/wp-content/uploads/2024/03/Welcome-Package-Solo-Practice-March-2024.pdf

Practice Share: http://www.rideaucrossingfhc.ca/sample2/wordpress/wp-content/uploads/2024/03/Welcome-Package-Shared-Practice-March-2024.pdf