PATIENT FORMS
Click on the links below to open and download or print the form appropriate to your request or upcoming appointment.
NEW PATIENT FORMS
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Adult New Patient Packet (all forms)
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New Patient Information Form (individual form)
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Privacy Directives (individual form)
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Health Information Release Form (individual form)
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Child New Patient Packet (all forms)
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Child New Patient Information Form (individual form)
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Child Privacy Directives (individual form)
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Child Health Information Release Form (individual form)
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CONSULTATION FORMS
Please return your forms to Dr. Maijer's office in person, by email, fax or mail.
FAX
(855) 266-0505
Dr. Rolf Maijer
4464 West Saanich Road
Victoria, BC V8Z