Web Appointment Request-Page 2 Template

Physical Exam/Check Ups for the purpose of a 3rd Party:
ie. Ministry of Transportation, Insurance Request, Employment or Pre-Employment, and SuperAnnuation for pension buy-back.
You have just requested an appointment for a 3RD Party Physical.
Please select the ‘back’ button if this was not your intention. This appointment request is
only for the intended program*.
How to prepare for your appointment:
1. Bring a Pen
2. Bring ALL current medications in a bag, or on a list with product names and
dosages listed. Include: Pills, Puffers, Patches, Sprays, and over the counter
medications.
3. Bring any recent lab test (less than 6 months old) results if available.
4. Wear loose fitting clothing that is easy to change in and out of.
5. If you wear eyeglasses, bring them with you for the eye test.
6. Be prepared to provide a urine sample.
7. Bring all required forms to the appointment.
8. Complete Your Part of ALL Forms in advance, highlight any questions or areas of
the form you are uncertain about.
9. If possible, take your Blood Pressure at a local mall or pharmacy and bring the
measurement results with you.
Note of Medical Interest for Ontario Patients:
According to Ministry of Health rules, Doctors are not allowed to combine a regular
Annual Exam with any 3rd party checkup, nor to perform an Annual Exam within 90 days
prior to OR after the 3rd party check up. As an unfortunate result, most patients in
industries that require these check ups do not get the routine services (blood tests,
Prostate Test, Mammogram etc..) recommended for health screening. Please ask the
doctor if they could order or perform these ‘missing’ tests for you at the time of your
visit, unless you have plans to come back for a repeat physical in 90+1 days.
Special Note: Travellers/Visa applicants to Saudi Arabia: Due to the unusual
complexity of these particular embassy forms you will be charged an additional $80 for
the subsequent (2nd) visit and services required.
Contacting you with your appointment information:
By providing your email you acknowledge and consent to our staff emailing you the
appointment details at that email address.
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Email is preferred as telephone contact can be difficult; for privacy reasons no message
details can be left on a message service or with another person
Please be advised that you will be contacted by one of our staff within 3 days.
Please ensure your email settings allow mail from the address:
[email protected] and if you use Hotmail, make sure you check
your Bulk Mail folder regularly until you change your settings to accept this address into
your inbox.
Age of Consent:
Please be advised that children under the age of 16 will not be seen without a parent
or guardian.
Please bring your Health Card to each and every visit (no exceptions).
*Using this email appointment request service to contact us for any other unrelated reason may lead to a
loss of your online booking privileges with our group. Requesting an appointment does not constitute the
establishment of a therapeutic relationship. In the rare event that you do not receive appointment
information within 3 days by email or phone call, please send a second request.
INFORMATION GÉNÉRAL POUR LES PATIENTS DU QUÉBEC
....................................................................................................
Le groupe médical Appletree souhaite la bienvenue aux patients du Québec
dans tous nos emplacements.
Lorsque vous avez besoin d’aide médicale, NUL besoin de téléphoner ;
consulter l’outil Temps d’attente (à la gauche) et optez pour
l’emplacement le plus près de chez vous ou le centre ayant le temps d’attente le plus
court.
Les patients du Québec devront payer pour tout type de services médicaux au
moment de leur visite et seront partiellement remboursés (selon l’équivalence des
taux du Québec) en faisant parvenir le formulaire de remboursement par la poste
avec le reçu fourni lors de la visite. Pour vous accommoder, les formulaires de
remboursements vous sont disponibles pour téléchargement et impression à même
cette page (lien à la droite). Prière de compléter ce formulaire avant la visite ou
lorsque vous attendrez en salle d’attente. Notre personnel y apposera une
étampe après votre paiement.
Postez votre formulaire de remboursement à :
RAMQ PO Boîte postale 6600 Québec, Québec G1K 7T3
Tous les services offerts aux patients de l’Ontario le sont également pour les
patients du Québec.
Information importante pour faciliter les soins aux patients du Québec :
Si le Médecin prend un échantillon devant être testé en laboratoire : i.e. un
prélèvement sanguin, une culture, un frottis pap, etc. Vous devrez joindre cet
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échantillon à votre demande (dans le sac fourni à cet effet avec la demande vous
étant remise par le médecin) et l’envoyer au Laboratoire Gamma Dynacare le
plus près de chez vous. Gamma Dynacare accepte la carte médicale du Québec si
vous vous présentez dans l’un de leurs emplacements de votre ville. ( Sélectionnez
Lab Locations de l’outil Health Directory pour connaître le numéro de téléphone
et l’emplacement le plus proche). Centre-ville d’Ottawa : Rendez-vous au 381 rue
Kent pour y apporter vos échantillons.
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