DR. EISNER'S PATIENTS

Please complete to confirm you would like to continue to be a patient of Malvern Medical Centre. MOST patients will be booked with Dr. Gordana Popovic but some will be placed with a different doctor in the clinic

Please note:
Patients will be divided up between Dr. Popovic and the other physicians RANDOMLY in keeping with CPSO policy.
**This is beyond clinic and staff control**

PLEASE COMPLETE A SEPARATE FORM FOR EACH FAMILY MEMBER