CCMSBC Physician Service Registration Form

This form is for the benefit of our members, and potentially for all BC physicians at large.  A list of services will be provided to all members after enough members signed up.

Specialty: e.g. Rheumatology, Family Medicine

Accepting new patients or new referral: Yes, or No

Language spoken: languages other than English

Location of the service, e.g. Burnaby, Surrey.

Please note: all fields are mandatory, and after clicking on "submit", wait for confirmation: "Thank you ... ..."