New Patient Intake Form

To protect your privacy, please do not include specific medical details in this form.

By submitting, you consent to our use of secure, encrypted digital platforms to process your request, which may involve routing data outside of Canada, and acknowledge you have been offered alternative methods. Your information is managed in strict accordance with PHIPA, accessed exclusively by authorized Aegis Clinical staff, and never shared without your explicit consent.

Alternatives: You can also register by calling 437 848 0310, emailing info@aegisclinic.ca or visiting us in person.