top of page

Medical History

Click 

  • Open and fill or print and fill the PDF document

​​

  • Email (retina0001@gmail.com), mail or bring the filled Medical History form with you for your appointment

OFFICE LOCATION

1 - 4101 Dewdney Ave.

Regina, SK S4T 1A5

Appointment by referral only

​

​

Tel: 306 522-3937

Fax: 306 522-8252

bottom of page