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“ONE LIFE, LIVE INSPIRED”
Women's Wellness Clinic

"Compassionately Addressing Women's Health Issues"

Patient Registration

We welcome new patients. To register with Varsity Women's Wellness please fill out the form below.
Fields marked with the * denote required information.

First Name *
Last Name *
Reason for Visit
Birth Date (Day/Month/Year)*
Street Address*
Apartment / Suite Number
City*
Province*
Postal Code*
Preferred Phone Number*
Email Address*
Parent / Guardian (if applicable)
Relation
How did you hear about our clinic?






Varsity Medical and Wellness, a unique one-stop-shop for all your health and wellness needs. We offer a wide array of services to serve you and your family all centered in our state of the art facility.



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