top of page

Connect to A Nurse

Please complete the following intake form to be contacted by the next available registered nurse. If you need a health assessment within the next 24 Hours please call directly at 403-479-2626.

Site Menu 1

Client Intake Form

For general inquiries please visit our contact page here.

Section 1: Contact Information
Are you requesting an appointment on your own behalf?
Section 2: Client Information
Your information is kept confidential. Read our privacy policy here.
When is the best time for us to contact you? Select all that apply is a healthcare advertisement agency connecting individuals to healthcare providers across Alberta. We do not take liability for our listed healthcare professionals that may contact you. By agreeing to the terms & conditions below, the individual(s) written in section 1 of this form is in agreement to our Liability/Privacy Policy.
bottom of page