By submitting this form, I acknowledge and agree to the following:

• The information I have provided is accurate and complete to the best of my knowledge.
• Haven Medical Clinic may collect, use, and securely maintain my personal health information in accordance with applicable British Columbia privacy legislation for the purposes of medical care and clinic administration.
• Haven Medical Clinic may communicate with me by phone, voicemail, email, or secure electronic portal regarding appointments, test results, and other healthcare-related matters.
• Haven Medical Clinic may request relevant medical records from my previous healthcare providers to support continuity and safety of care.
• My physician may access relevant health information through provincial systems (such as CareConnect) to support safe and informed medical care.
• Haven Medical Clinic may use secure electronic medical record systems and documentation tools, including AI-assisted clinical documentation technology, and all documentation is reviewed and finalized by my physician.
• Prescriptions and medication renewals require appropriate clinical assessment and are provided at the professional discretion of the physician. Continuation of previously prescribed medications, including controlled substances, is not guaranteed.
• Submission of this form begins the intake process but does not guarantee acceptance into the clinic panel.
• A physician-patient relationship is established only after a meet-and-greet appointment and formal confirmation by the accepting physician.
• Until my registration is confirmed and a physician-patient relationship has been established, I understand that I should seek appropriate medical care elsewhere for any urgent health concerns.