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Alzheimer Care Partner Support Group
Anxiety - Dial It Down For Teens! (ages 14 - 18)
Anxiety - Dial it Down!
Better Sleep
Calming Difficult Emotions Group
Caring for a Loved One with a Mental Health Issue
CBT for Anxiety & Depression - 6 Classes
Chronic Disease Self-Management Program
Chronic Pain Self-Management Program - 6 Sessions
Cooking Class
Falls Prevention
Heart Health
Learn To Manage Osteoarthritis - 3 Sessions
Learn To Manage Your Fibromyalgia
Mood & Food
Parents of Teens with Mental Health Concerns
Prime Timers
Relaxation & Stress Management Skills - 6 Sessions
Understanding & Managing Your Diabetes - 2 Sessions
Understanding Pre-Diabetes
Walk-Fit Class
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Menu
COVID-19 at EWFHT
COVID-19 Information Centre
Clinic Hours
Fees & Services
Health Card FAQs
Online Booking
Prescriptions
Saturday Urgent Care
Waitlist Application
Walk-In Clinics
What's New in Healthcare!
Zero Tolerance Policy

Waitlist Form

Please note that if you have completed a paper waitlist form you don't need to complete an electronic one, and vice versa. Paper and electronic submissions are handled in the same way.
Waiting List Patient Information
First Name
Last Name
Date of Birth
Gender
Female  Male  Other / Prefer not to disclose  
Address
City
Postal Code
Home Phone #
Work Phone #
Mobile Phone #
Email
Do you have any significant health concerns?
Have you been a patient of East Wellington Family Health Team in the past?
Yes No
Name of current physician (if any)
Current physician city
Clinic Preference
Erin  Rockwood  Either/First Available  
Physician Preference
Male  Female  Either/First Available  
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Unit 1 • 6 Thompson Crescent • Erin ON N0B 1T0 • Phone: (519) 833-9396
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