Unit E 310 8th Street
Courtenay, BC
V9N 1N3
}

Mon-Fri: 8am-4pm

Sat & Sun: Closed

Phone: 250-331-0500

Fax: 250-331-0553

Electronic Communication Consent Form for ValleyCare Medical Patients

Please read the above and fill out the fields below to acknowledge this agreement.
mailing address: street, city, postal code
name & city of location