Doctor Application

Join the platform and start accepting new patients in your region. Our team will review your application within 1 to 2 business days.

Professional Details

First Name *(required)

Last Name *(required)

Business Email Address *(required)

Create a Password *(required)

You'll use this with your email to log in to your dashboard later.

Confirm Password *(required)

Medical License Number *(required)

As issued by your provincial regulatory college.

Province *(required)

City *(required)

Region / Area *(required)

Clinic Information

Clinic Name *(required)

Clinic Address

Preferences & Links

Languages Spoken *(required, select at least one)

English French Arabic Mandarin Punjabi Spanish Other

Do you provide interpreter services?

Yes No

Booking Calendar Link *(required)

Patients will use this to book their appointment.

Video Meeting Link *(required)

Google Meet, Zoom, Teams, or any video link you use.

Current Availability *(required)

Accepting new patients now Will be available soon Not currently accepting, just registering

Anything else you'd like us to know?

I confirm that the information provided is accurate and that I am a licensed physician in Canada. I consent to Quick Clinic Connect sharing my clinic details with patients who are looking for a family doctor in my region. *

Your information is protected under the applicable Canadian privacy legislation.
Questions? Email STAFF2025@quickclinicconnect.onmicrosoft.com

Application submitted

Thank you for applying. Our team will review your information and get back to you within 1 to 2 business days.

← Back to Quick Clinic Connect

Quick Clinic Connect Virtual Clinic

Connecting Canadians with family doctors through a secure, simple, and free virtual waiting list.

Patients

How It Works
Join Waiting List
FAQs

Doctors

Join the Platform
How It Works
Apply Now

Company

About Us
Contact
Privacy Policy