Community Registration Form - 2024

Your personal information will remain confidential and will be sent securely through our website. The information you provide will help us to better identify and respond to the needs of the clients and participants we serve.

I would like to register for the following activity: *

I am also interested in other activities such as:

Have you ever registered for a course / workshop / program offered by the West Nipissing Community Health Centre, either virtual or in person? *

I have already registered.
This is the first time that I register (note: you will only have to complete this form once).

Name *

First

Last

Address *

(Street, Town, Postal Code)

Email *

I accept to receive emails as part of this course. *

By submitting this form you indicate that you have read this form and that you agree with the principles as stated.

Accessibility

West Nipissing Community Health Centre strives at all times to provide its services in a way that respects the dignity and independence of people with disabilities.

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Contact Us

68 Michaud St.
Sturgeon Falls, ON • P2B 1B8

Tel: : (705) 753-0151
Fax:: (705) 753-5387

info@cscno-wnchc.org Please be advised that this email should not be utilized for emergency purposes, to share medical information, or to book/cancel a medical appointment.

Hours of Operation

Mon, Tue, Thu: 8:00am – 4:00pm
Wed: 7:00am – 6:00pm
Fri: 8:00am – 1:00pm

The WNCHC has access to shared electronic medical records (EMR) through eHealth Ontario’s /ConnectingOntario/, but does not contribute any client information to this shared EMR.