Medical Clinic Intake Form

Kindly submit the forms at the clinic’s reception

Finding a family doctor is essential for maintaining your health and wellness. If you’re looking for a trusted medical clinic in Surrey, BC, or White Rock, BC, you’re in the right place! At our walk-in clinic, we’re dedicated to providing personalized and comprehensive care for all our patients. Here’s how you can join our clinic and take a step toward better health by submitting your intake form.

Why Choose Us?

Our walk-in clinics in Surrey and White Rock are designed to offer quality healthcare for everyone. Whether you need routine check-ups, help managing chronic conditions, or urgent care services, we’ve got you covered. From children to seniors, we cater to diverse health needs with compassion and expertise.

How to Submit Your Intake Form

Joining our clinic is simple! Follow these steps to ensure a smooth process:

  1. Download the Intake Form

Visit our website or contact us directly to get your intake form. Be sure to complete all sections with accurate information.

  1. Choose Your Submission Method
  • In-Person Submission: This is the most secure method. Drop off your completed form at the reception desk of our walk-in clinic near you.
  • Email Submission: If visiting in person isn’t possible, you can email the form. However, email submissions may carry privacy risks.

Email Addresses for Submission

  • White Rock Clinic: wrmoa@citymedhealth.ca
  • Surrey Clinic: medical@citymedhealth.ca

Important Notes

Temporary Pause in Surrey Intake

Currently, we’re unable to accept new patients at our Surrey walk-in clinic due to high demand. Please avoid emailing or dropping off forms for the Surrey location until we reopen intake. Updates will be shared on our website and social media.

Specify Your Practitioner

On the intake form, clearly indicate whether you’re applying for care from a family doctor or a nurse practitioner. This helps us process your application faster.

What Happens After Submission?

Once you’ve submitted your form:

  1. Our team will carefully review it.
  2. We’ll notify you once your application is processed.
  3. Please avoid calling the clinic for updates—we’ll reach out as soon as possible.

Walk-In Services Availability

If you need immediate care, our walk-in appointments are available at the Surrey clinic. Keep in mind that slots fill up quickly due to high demand.

Walk-In Clinic Hours

  • Monday to Thursday: 4:00 PM – 8:00 PM
  • Saturday: 11:00 AM – 3:00 PM

To book, call +1 (604) 503-9966.

Comprehensive Healthcare Services

Family Medicine

Our team of skilled family doctors provides care for all age groups, from newborns to seniors.

Women’s Health

We offer specialized services such as wellness check-ups, prenatal care, and menopause management.

Men’s Health

From annual physicals to chronic condition management, we prioritize men’s health needs.

Senior Care

Our clinics are experienced in handling geriatric health concerns with compassion.

Why Timely Enrollment Matters

Having a family doctor near you ensures continuous care for your medical needs. By joining our clinic, you gain access to:

  • Preventative care
  • Chronic disease management
  • Personalized health advice

Join Us Today!

Your health is our priority. If you’re looking for a reliable family doctor in Surrey or White Rock, don’t wait! Complete and submit your intake form today. We look forward to helping you and your family stay healthy.

🇨🇦 Proudly Canadian and locally owned and operated. Our doctors and nurse practitioners are now accepting new patients.

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