Join Our Kitchener Practice

Mango Tree FHT presently not taking patients for the  waiting list to become a patient.

First Name, Last Name (required)

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Postal Code (required)

Age

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Home #

Mobile #

Are you registered with Health Care Connect?(required)

Previous Family Doctor (required)

Medications (required)

If you are not currently taking any medications, please write "None" in the field above.

Medical Conditions

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