military family doctor network - calian · step 2: fax to: 1-888-511-0219 scan and email to:...
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Main Contact:__________________________________________________________________________________________
Patient’s Name: ________________________________________________________________________________________
Patient’s Name: ________________________________________________________________________________________
Patient’s Name: ________________________________________________________________________________________
Patient’s Name: ________________________________________________________________________________________
Patient’s Name: ________________________________________________________________________________________
Phone Number: _____________________________________
Email:______________________________________________
For verification of eligibility for this program we require the CAF member’s:
Name: ___________________________________________ Work Phone:___________________________________
Rank:____________________________________________ Work Location:_________________________________
Current status: Serving Retiring Releasing
Calian is pleased to offer a Military Family Doctor Network (MFDN) in support of the Military Families across Canada. The program is presented in coordination with the local Military Family Resource Centre. This is the beginning of a national program that will link Military Families with doctors within the network of 140 Calian Primacy health clinics.
If you require a family doctor, follow these three simple steps:
Step 1: Complete the form Step 2: Fax to: 1-888-511-0219 Scan and email to: [email protected] Call: 1-877-633-7722 x 550 Step 3: A representative from Primacy will contact you at the phone number provided below
Physician preferences: Male Female Either
Language Preference: ______________________________________________________
Medical coverage: Manitoba Health Other: ________________________________________________
In what area do you live? Please include your postal code:______________________________________________
How did you learn about the MFDN ? ____________________________________________________________Note: Please ensure that you inform your doctor when you change doctors as another family may be waiting.Disclaimer: MFDRP is limited to connecting CAF families with participating physicians. MFRC-Winnipeg is not involved in the patient-doctor relationship beyond the introduction.
Revised 23.09.15 MFDN REF #
WALK-IN CLINICSPlease see reverse for a list of convenient Walk-In Clinics should you require immediate medical assistance.
As the Canadian Armed Forces long-time health services partner, Calian is honoured to extend our services to support Canadian Military Families within the communities where they live, work and play.
Military Family Doctor Network
Halifax & Region Military Family Resource CentreCentre de resources des familles militaires d’Halifax et régions
* Call for hourswww.primacyclinics.ca
Pharmacy on-site at each location!
Saint Mark Medical Clinic2132 McPhillips StreetWinnipeg, MB R2V 3C8(204) 416-0038
Gateway Medical Clinic1035 Gateway RoadWinnipeg, MB R2K 4C1(204) 667-5227
Haven Medical Clinic3193 Portage AvenueWinnipeg, MB R3K 0W4(204) 832-4644
Regent Medical Clinic1578 Regent Avenue WestWinnipeg, MB R2C 3B4(204) 654-3083
Bison Family Medical Clinic1-80 Bison DriveWinnipeg, MB R3T 4Z7(204) 275-1500
St. Anne’s Medical Clinic215 St. Anne’s RoadWinnipeg, MB R2M 2Z9(204) 254-2464
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Primacy Walk-In ClinicsWhile you are waiting to be referred to a Family Physician, we welcome you to visit
one of our Walk-in Clinics with any urgent care needs.
Halifax & Region Military Family Resource CentreCentre de resources des familles militaires d’Halifax et régions