Patient Forms

    Patient Forms

    Please have a medical history form completed for yourself or your child before you arrive.These forms are required at your first visit, and information submitted from these forms will be kept confidential and on file for future reference.

    Medical History Form - Adult Medical History Form - Adult (492 KB)

    New Patients

    Please complete a medical history form and bring it to your first appointment:

    For Adults For Children

    Burnaby Clinic Hours

    • Monday - Wednesday 9am - 5pm
    • Thursday  7:30am - 3:30pm

    Terrace Clinic Hours

    • Monday - Wednesday 7:30am - 5pm
    • Thursday  8am - 4pm


    "Dr. Jeannotte and his team are caring, professional and give back to their community." Clara N., Vancouver, BC