Patient Forms


On this page you will find a variety of patient forms. Please download and print off anything you might need, and feel free to call  the Thornhill office at 905-886-1212.

Thornhill Referral Form

Our new referral form can be printed off and filled out with the patient and referring doctor’s information. Please keep in mind that E-Consultations can only be initiated by a doctor and that information sent to us by patients via email (gmail, yahoo, hotmail etc.) will not be viewed by our team. The security of patient information is very important to us; please help us protect your medical data by allowing your family doctor to safely and securely send us your documents through electronic means. If you have any questions about our new referral form, please call the office at 905-886-1212.

Download the Wilderman Medical Clinic Referral Form here:

Wilderman Medical Clinic Referral Form (PDF)

Uninsured Services

Our office provides a wide range of services, some of which are not covered by OHIP. The following form outlines the payment options available to patients, depending on the frequency of the services required. If you are having trouble understanding the structure or if you need assistance with this or any other patient forms, please call the Thornhill office at 905-886-1212. Please keep in mind that this payment structure is only for the Thornhill office.

Download the guide to uninsured services here:

Guide to Uninsured Services (PDF)

Exercises for Better Back Health

These are the best exercises available for strengthening and maintaining good back health. Please speak to our doctors about how to safely integrate these exercises into your routine before you start using them. Call either Thornhill office at 905-886-1212  if you have questions about patient forms or wish to make an appointment with our doctors to discuss the right exercises for your situation.

Exercises for Better Back Health (PDF)

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