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DR. ATHEER MIHYAWI IS ACCEPTING NEW PATIENTS —
BECOME A PATIENT TODAY
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Dr. Atheer Mihyawi
New Patient Registration
Contact Us
Home
Dr. Atheer Mihyawi
New Patient Registration
Contact Us
New Patient Registration
Become a patient of Dr. Atheer Mihyawi at Seven Star Medical Center in just a few clicks.
New Patient Registration Form
Looking for a
family doctor accepting new patients in Hamilton, ON
? It’s as easy as 1-2-3!
Fill out some quick info below in our secure form
to register as a new patient with Dr. Atheer Mihyawi and a team member will be in touch shortly to confirm!
Full Name
Date of Birth
Gender
Select
Male
Female
Other / Prefer Not To Say
Health Card #
Address
Email
Phone Number
Emergency Contact (Name + Phone)
Marital Status
Married
Widowed
Separated
Divorced
Single
Occupation
Current Family Doctor (If Applicable)
Preferred Pharmacy (If Applicable)
Smoking?
Select
Yes
No
Alcohol?
Select
Yes
No
Past Medical History:
Past Surgical History:
Current Medications
Social & Family History
List any medications you take for chronic pain:
List any sleeping medications you take:
SUBMIT
