Registration Form for Patients of Dr. Saboya If you are a patient of Dr. Saboya at Ste-Anne Medical Centre and wish to follow her to Santé Alliance Health, please submit the following form. Please submit one form for each family member. Health Card Number Version Code for OHIP cards with a photo First Name Last Name Email I agree to be contacted by email Yes Date of birth Street Address (including unit number, if applicable) City Province Ontario Post Code Primary Phone Number Can a voice message be left at this number Yes No Secondary Phone Number Can a voice message be left at this number Yes No Please ensure all fields are filled and then click submit Submit
