Forms

In certain circumstances patients of Associate Clinic are able to communication with their physician electronically through secure e-mail or arrange a video appointment using Medeo Virtual Care.

If you would like the option to arrange secure video-chat appointments or communicate with your physician via secure e-mail please print out and complete the form below and e-mail a copy of the completed from to admin@associateclinic.com and your consent will be recorded in your Associate Clinic patient file. Alternatively you can bring the completed form with you to your next in-person appointment.

Consent my be withdrawn at any time by e-mailing admin@associateclinic.com