Enrolment Forms for existing patients ONLY

For patients already registered with a physician at South Ottawa Medical Centre (SOMC)

If you are an existing SOMC patient and need to complete or update your enrolment, please follow the steps below:

1. Download the Enrolment Forms

Click the PDF icon below to download the required forms.

2. Complete and Sign the Forms

You may fill out the forms electronically or by hand. Please ensure that both of the following pages are signed:

• Page 1: Patient Enrolment and Consent to Release Personal Health Information

• Page 2: Patient Health Care – New Patient Declaration

3. Return the Completed Forms

Choose one of the following options to return your signed forms:

a. Drop-Off

You may drop off the completed forms in person at South Ottawa Medical Centre during regular office hours.

b. Mail

Send the completed forms by mail to:

South Ottawa Medical Centre
2-1650 Queensdale Avenue
Gloucester, ON K1T 1N8

c. by fax

You can fax us the forms to 613-244-3399

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Important Note:

Forms submitted by individuals who are not currently registered with a physician at SOMC will be discarded.