Leading the way

Patient Documents, Medical Forms and More

The following clinic forms are available for your convenience. If your next visit requires completion of a certain form, please print and fill it out, and bring it with you to your next appointment. Please Note: We are not accepting new patients at this time.
Patient Forms

Health Improvement Action Plan

Our Health Improvement Action Plan is a personal goal setting and action planning tool for health related matters. You may be asked to download this document by your care provider. Alternatively, our patients are free to use this for their own purposes as well.

Download PDF

Health Questionnaire

If you are a new patient at Gateway Healthcare, and have booked a Meet & Greet appointment (1st visit) with one of our providers, please complete this Health Questionnaire form and bring it to your Meet & Greet appointment. The purpose of the Health Questionnaire is to collect a complete medical history, and therefore populate your electronic medical record with up to date, comprehensive, and accurate information. Please include as much information as possible. This form will be reviewed by your health care provider at your Meet & Greet appointment. Depending on the complexity of your medical history, your provider may request you book a Health Questionnaire visit with our nurse. The details of this visit will be explained to you at your 1st visit. A fee may apply to the processing of this form in conjunction with the receipt of your previous medical records.

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Complete Medical Questionnaire

If you are booked for a complete medical visit with your provider, please print and fill out the Complete Medical Questionnaire, then bring it to your Complete Medical visit. This form will provide your physician with an update on your most pressing concerns.

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Patient Registration Sheet

If you are a new patient at Gateway Healthcare, we want to know how to keep in touch with you! Please print and fill out this form, then bring it to your first visit (Meet & Greet) with your provider. This form will ensure your contact and family information is accurate and up to date in our system.

Download PDF

Fee Schedule

In some cases, a physician’s review of a form is not a service covered by the Medical Services Plan of BC. In these cases, a private fee, payable by the patient, applies. This fee will be explained and collected when you check in for your appointment. Please see the link to a fee schedule below for more details.

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