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  • See a Doctor 100% Covered by OHIP

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  • Format: +1 (000) 000-0000.
  • OHIP Number

    This allows us to offer your appointment for free. If you don't have this handy you can provide it before your appointment.
  • Was this intake form filled out by anyone other than the patient?*
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  • This pharmacy has been installed with medical devices that allow for initial assessment and collection of vital signs when beneficial and clinically relevant to your concern. Is your pharmacy able to assist you with the use of the device?
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  • Have you been diagnosed with COVID-19 in the past 6 days?
  • Do you feel like you might benefit from physiotherapy?
  • We just launched a new pilot diagnostic device program for screening patients for overall health and well-being. These devices may help to prevent an in-person visit and will provide the doctor the information needed to help deliver a higher quality of care.
  • Would you be interested in participating in a research study that monitors patients with COVID-19 using an at home portable lung ultrasound device?
  • *By requesting an appointment, you agree to Rocket Doctor’s Terms and Conditions, Email Communications Policy, Informed Consent, and Privacy Policy.

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