Request to Transfer

Horizon Family Health Center

Please do not forward this link to anyone else.

If you are receiving this email then you were NOT selected to move to Murrayville Family Practice - we had so much interest and could only select a fraction of the requests we received!

Fortunately we have another opportunity to transfer 200 patients to Horizon Family Health Center in Murrayville (beside the Langley Hospital)

Please complete the form below if you are interested in transferring your care to Dr. Manpreet Takhi

This is not a guarantee of transfer but a consideration for transfer.

DO NOT CALL THEIR OFFICE - If you contact them YOU WILL BE REMOVED FROM THE TRANSFER LIST

We hope we can facilitate this transfer within the next 6 months as this seems to be a lengthy process

https://horizonclinic.ca/

Your information is being collected for the sole purpose of contacting you for potential registration

Name

First Name

Last Name

Entering your email address implies consent for Fort Family Practice to contact you via email.

Phone

Please enter the best number to reach you at. If we are unable to reach you, we will leave a message.

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Immediate family members for waitlist

If you have *immediate* family members (parents, spouse, children) that you would like to be waitlisted along with you, please add their names below (ONE LINE PER PERSON). The person completing this form will be considered the primary contact person for the family, regarding the waitlist.