New Patients: To Book Your First Appointment Fill Out This Form —>

or Call 647- 484 - 4923

Note: after filling out this form you will receive an email and/or call from our clinic to find you an appointment time. This information is then put into our electronic medical record system which will email you an intake questionnaire and ask you to create a username and password to use for accessing your chart and information the doctor(s) will be sharing with you..

For patients interested in the stroke recovery and brain rehab program, please fill out this form and a member of our staff will contact you for a complimentary discovery call or meet and greet.

 
Name of Patient *
Name of Patient
Phone of Patient or Patient Representative *
Phone of Patient or Patient Representative
We may call you to facilitate booking your appointment
Date of Birth of the Patient *
Date of Birth of the Patient
Required to set up an electronic medical record for you. All information is confidential.
Birth Sex
I want the office to direct bill my benefits provider for me, using e-Telus Health Claims. I will include my benefit details in the intake form and I have read what could be covered under my plan on the website at: https://www.bellwoodswellness.com/billinginfo. *
Please read the direct billing questions to ask your insurance provider, and codes we use with e-Telus Health, to direct bill for patients. www.bellwoodswellness.com/billinginfo
What day of the week is best for your in-person appointment(s)?
What time of day works best for your appointment(s)?
Are you looking for an appointment for the Stroke Recovery 2-month program? *

Rouge Valley hospital TORONTO STROKE RECOVERY PROGRAM

2867 Ellesmere Rd, Unit #110
Toronto, ON, M1E 4B9
Canada

Hours: Wednesdays, 8:30am-4pm

Call: 647 - 484 - 4923

LEARN MORE ABOUT THE PROGRAM HERE

Bellwoods wellness and naturopathic medical clinic

General Naturopathic Care and Stroke Recovery Consults

237 Crawford Street
Toronto, ON, M6J 2V5
Canada

Hours: Tuesdays & Thursdays, 9:30am-6:00pm, Fridays 9:30am-12pm

Call: 647-484-4923