APPLICATION FORM (click here)    

Health Zone takes new patient applications based on NP availability. Completing an application to be a patient does not guarantee that you will be accepted as a patient. At this time any new patient applications will  be reviewed as capacity for new patients allow. Each application is reviewed to be sure we are the right provider for you. 

Please fill out a seperate application for each person applying. 

In order for us to consider your application, the following criteria must be met:

  • Completion of a new patient application form (a seperate application for each family member applying)
  • Currently have a permanent address in London Middlesex and surrounding areas
  • Do not have a primary care provider (family doctor/physician or Nurse Practitioner)
  • Sign the application form indicating the information provided is true and accurate

Once you apply, please do not call the office to inquire about the status. We will call you only if we are able to offer you an intake appointment.

We also recommend that you register at Health Care Connect to be put on a waiting list for a Family Physician or Nurse Practitioner in your area.