When filling out your legal name, please ensure it is written exactly as it appears on your Ontario Health Card.

If there is space, we will contact you within two weeks of your form submission. Unfortunately due to the high amount of requests we receive, we do not have the capacity to make contact if we are unable to accommodate you. Please assume that if you have not heard back from us after two weeks, then you have been placed on our waitlist.

If you have difficulty completing the application below, please contact us at (416) 530-7468.

Please note that if we contact you, we will leave a message so please make sure to check your voicemails. If we are unable to leave you a message, we will email you directly, so please make sure to check your junk or spam. If you are going to be out of the country at any time and will therefore be unable to take international calls, please let us know in your application. We hold spots for one week after we first attempt to make contact. We call or email twice. If after this time we do not receive a response, we will assume you are no longer interested in care and will proceed with the next person on our waitlist.