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Fresh Bay Medical Centre

New Patient Intake

Complete the patient intake and office policy form.

New Patient Intake

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Patient Information

Medical Provider

Important Notice

Before completing this intake form, please ensure you have registered with the Government of British Columbia Health Connect Registry: https://www.healthlinkbc.ca/find-care/health-connect-registry


If you have not completed this registration, your intake form will not be considered valid and our providers will not be able to accept you as a new patient.

Code of Conduct and Practice Policies

Fresh Bay Medical Centre policies

1. Code of Conduct: We provide care to all individuals regardless of religious affiliation, race, gender identity, or socioeconomic status. We expect all patients, visitors, and team members to treat one another with dignity and respect. We maintain a zero-tolerance policy for harassment, discrimination, threats, or violence. Any such conduct may result in immediate termination of the care relationship.


2. Appointments: Please arrive 5–10 minutes before your scheduled appointment time. Consultations may be limited to one primary issue per appointment. Arrivals more than 10 minutes late without prior notification may be considered a no-show. Cancellations must be made at least 24 hours before the scheduled appointment. A $95 no-show fee will be charged for missed appointments and must be paid before future appointments can be scheduled.


3. Prescription Refills and Renewals: Refills are not routinely processed by fax or telephone. Please schedule a follow-up appointment before your medication runs out.


4. Uninsured Services: Services not covered by MSP, including sick notes, third-party forms, cosmetic procedures, and other non-insured services, are subject to applicable fees.


5. Electronic Communication Consent: I consent to the clinic communicating with me through email, SMS, and fax. I understand these methods may involve privacy and security risks. I may withdraw or modify this consent by providing written notice.


6. Termination of the Physician–Patient Relationship: The relationship may be terminated when appropriate, including harassment or abusive behaviour, repeated lateness, excessive use of outside clinics for ongoing care, or a significant breakdown in the relationship.

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For a medical emergency, call 9-1-1. Do not use this form for urgent medical advice.