How to become at Patient at CLFHT

Anyone interested in becoming a patient of one of our new physicians please print off enrollment forms below complete forms and bring to the CLFHT office; 4130 Glenview Rd. Unit #3, Petrolia. Monday- Friday 9:00am-12:00pm, 1:00pm-4:00pm or call (519-882-2500) for more information.

  • MOHLTC Enrollment form,
  • Patient Medical Information Sheet,
  • Request for Medical Records (from previous physician)
  • Emergency Contact and Pharmacy information.
  • Each person age 16 or over must complete their own set of forms.

Children under the age of 16 may be included on parent/guardian's MOHLTC Enrollment Form and must have their own Medical Information Sheet, Request for Medical Records, and Emergency Contact Information Sheet.

These packages can be completed in office or may be taken home for completion.

All patients registering must present a VALID health card, with the completed package at the time of registration.

Patients will be scheduled for a new patient appointment, at a later date.