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Register as a New Patient

Welcome to Leslie Medical Pharmacy. Please complete the form below to register as a new patient. Once submitted, our team will review your information and contact you if we need anything further.

First Name *

Middle Name

Last Name *

Date of Birth *

Address *

Phone Number *

Do you have insurance? (optional)

By submitting this form, you agree to our Privacy Policy and Terms of Use.

Register as a new patient at Leslie Medical Pharmacy

Our pharmacy team is here to provide friendly, personalized care for you and your family. If you have any questions while registering, feel free to call us at (416) 498-4800.