452 Borland Street, Williams Lake, BC, V2G 1R7
Tel: 250-392-1971


Borland Medi-Clinic aims to be 98% paperless and therefore we have decided to go the extra mile and secure an online registration form. The information entered into this form is 100% safe and will only be used by Borland Medi-Clinic to create and update your electronic medical record. 

The information requested in this form is designed to help the physicians working in Borland Medi-Clinic to make better decisions for you.

Please mark any past medical conditions you have been diagnosed with before or currently receive treatment for:

Patient Consent to Access PharmaNet:

The Province of British Columbia has established the provincial computerized pharmacy network and database known as "PharmNet" pursuant to section 37 of the Pharmacists, Pharmacy and Drug Scheduling Act, R.S.B.C. 1996, c. 363, and which may be continued pursuant to section 13 of the Pharmacy Operations and Drug Scheduling Act, S.B.C, 2003, c.77 should it be proclaimed in force during the term of this Agreement.
I authorize all the physicians of the Borland Medi-Clinic and persons directly supervised by them to access my personal health information contained within PharmaNet for the purpose of providing therapeutic treatment or care to me, or for the purpose of monitoring drug use by me. I understand that withdrawal of this consent must be in writing and delivered to the physicians of the Borland Medi-Clinic.