Country Roads is now taking registration for new clients. To register, we need information about you and your health needs. We want to make this as easy for you as we can.
- If you have a computer and a printer, you can print the forms at home, complete them and bring them to our office in Westport or Portland.
- If you prefer to pick up a paper copy, we have them available for you at either office.
- If you would like us to mail you the registration forms, please call 613-272-3302 extension 228 or email firstname.lastname@example.org .
To provide you with the best possible care and assist you with your health needed we ask you to complete :
- A registration form
- detailed health questions
- A signed consent to obtain your previous health records
CLICK ON THE LINKS BELOW TO OBTAIN THE FORMS