New patients can call 204-325-4312 to register OR fill out the form below. For families, one contact can complete the registration for all family members by completing the form for each family member. Your First (Given) Name: Your Last (Family/Surname) Name: Contact name (if different from patient name): Contact phone number: Is the number provided, a cell number? (if so, we will send appointment notice by SMS/text) YesNo If you do not answer your phone, can we leave a message? YesNo Your PHIN (9-digit health number): your MHSC (6-digit health number):