Weight Loss/Diabetes Workshop - Halton Medix Clinic

Workshop Interest and Registration
Full Name*

First NameLast Name
Email*
example@example.com
Health Card*

Health CardVersion Code
Family Doctor Name*

First NameLast Name
I am a registered and active patient of Halton Medix?*

YesNo
Please note these Workshops are partly OHIP funded. Dietician fee needs to be paid in order to attend workshops.
Weight Loss Workshop

(5 Sessions - Partly OHIP Funded )
$50 per session for Dietician - weight loss workshop (can be covered by Insurance plans.)*

Yes Please! Register MeYes, but the date/time do not work for me, add me to next workshop’s waitlistNo, but I would be interested in workshops related to diabetes or cholesterol managementNo, I am not interested in workshops at this time but any future dates
Virtual workshops (Zoom) on Fridays 5-7 pm

Halton Medix Clinic
Weight loss Workshop Dates

Session 1 : Friday June 10, 2022

Session 2 : Friday June 17, 2022

Session 3 : Friday June 24, 2022

Session 4 : Friday July 8, 2022

Session 5 : Friday July 15, 2022
Diabetic Workshop

Learn how to acheive blood sugar targets ($50 Reg. Fee. )
$50 per session for Dietician - Diabetes workshop (can be covered by Insurance plans.)*

Yes Please! Register MeYes, but the date/time do not work for me, add me to next workshop’s waitlistNo, I am not interested in workshops at this time
Virtual workshops (Zoom) on Fridays 5-7 pm

Halton Medix Clinic
Please Select

Friday July 22, 2022Any future dates
Dyslipidemia Workshop

Learn how to improve high Cholesterol ($50 Reg. Fee. )
$50 per session for Dietician - Cholesterol workshop (can be covered by Insurance plans.)*

Yes Please! Register MeYes, but the date/time do not work for me, add me to next workshop’s waitlistNo, I am not interested in workshops at this time
Virtual workshops (Zoom) on Fridays 5-7 pm

Halton Medix Clinic
Please Select

Friday July 30, 2022Any future dates
* Please send etransfer to (please include your full name )

khameed@haltonmedix.com
* Payment should be received upfront. Please include your full name with etransfer refrance for the program you picked and date.

For any further inquiry please email haltonmedixwgtmgmt@gmail.com
COVID Consent*

I understand that I cannot attend inperson workshop If I/any family member / close contact have any sign and symptoms of COVID or pending test results.
Should be Empty:

Workshop Interest and Registration

Weight Loss Workshop

Virtual workshops (Zoom) on Fridays 5-7 pm

Halton Medix Clinic

Diabetic Workshop

Virtual workshops (Zoom) on Fridays 5-7 pm

Halton Medix Clinic

Dyslipidemia Workshop

Virtual workshops (Zoom) on Fridays 5-7 pm

Halton Medix Clinic

* Please send etransfer to (please include your full name )