registerIng Your newborn who is seeing a midwife

Wait, I’m not an active magenta health patient

If that’s the case, Our sincere apologies - we recommend that you look for another clinic to see your newborn at this time. Our new patient registration is currently mostly closed, with the exception of newborns of existing patients. Those patients can continue below.

Wait, Im an active patient, but my newborn is not seeing a midwife

If that’s the case, please go to our newborn registration page specifically for newborns who are not seeing a midwife.

I’m an active Magenta health patient and my Newborn is seeing a midwife

Your newborn typically does not need to see a physician until they are 2 months old. Nevertheless, it is useful to register your newborn baby with your Magenta Health family doctor as early as possible using the form below.

If there are no specific medical concerns that suggest an earlier appointment is warranted, we'll register your newborn and email you back inviting you to schedule a well baby visit for after the 2 month mark.

If you think an appointment prior to your newborn's 2 month birthday is needed, when completing the form, please indicate as such in the field "preferred appointment time". Once received, we'll contact you by email and phone to let you know of a date & time for your newborn's appointment.

The above information only applies to newborn babies who have a midwife:

If you have an older infant or child that you wish to register as a patient, please go through the standard patient registration process.
If you are a current patient who has already filled in the form below, and has received confirmation that your child has been registered, please use the ‘Well Baby’ option on your physician’s booking page in order to book their first visit after Midwife Discharge.

My own name is:

I am currently a Magenta Health patient

Yes, I am an active Magenta Health patient

No, I am not an active Magenta Health patient

My current Magenta Health physician is:

Your newborn's 10 digit health number?

e.g. 0123456789, 3821694372. It is usually provided to you when your newborn is discharged from the hospital.

Your newborn's first name?

Your newborn's last name?

Your newborn's sex?

Your newborn's date of birth?

Please defer completing this form until your newborn has been born.

MM

DD

YYYY

Date of Discharge from Hospital

MM

DD

YYYY

Preferred Appointment Date / Time for First Appointment

2 months for most newborns with midwives

Newborn Contact Information

Street Address (including unit number, if applicable)

City

Province

Postal Code

e.g. A1A 1A1

Email Address

Phone Number

(###)

###

####

Parent Information

If applicable, please share the details of your newborn's other parent. They will be contacted as well, and have the same permission and access to your newborn's file and information.

Name of Other Parent

Email of Other Parent

Phone Number of Other Parent

(###)

###

####

Consents

I agree to Magenta Health Inc. contacting me/us by email

Yes

Electronic Intake Paperwork during Covid-19

The documents that are normally provided during a newborn intake must be reviewed prior to your visit. These two documents are linked below this form. We ask you to review both links and explicitly confirm your consent before submitting this form. We will mark in our records that this has been done in lieu of asking you to supply a physical or virtually signed copy.

I have reviewed the "Email Authorization and Acknowledgement" form below - I consent

I have reviewed the "Patient Enrolment and Consent to Release Personal Health Information" form below - I consent

Forms for review prior to submission:

Email Authorization and Acknowledgement
Patient Enrolment and Consent to Release Personal Health Information

* Although the purpose of this process is for your newborn to become a patient of one of the family physicians at Magenta Health, please note that completing the above form alone does not make your newborn a patient yet.