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4648 IMPERIAL ST, BURNABY, BC V5J 1B8 T: 6044098000 F: 6044094000NEW PATIENT INTAKE FORM PATIENT INFORMATION LAST NAME (AS APPEARS ON BC SERVICES CARD):FIRST NAME (AS APPEARS ON BC SERVICES CARD):PREFERRED

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What is take back your treatment?

Take Back Your Treatment is a health initiative designed to empower patients by allowing them to reclaim control over their medical treatment options and care plans.

Who is required to file take back your treatment?

Patients seeking to alter or take control of their treatment plans, as well as healthcare providers who monitor or facilitate these changes, may be required to file.

How to fill out take back your treatment?

To fill out Take Back Your Treatment, individuals need to provide personal health information, specify desired treatment changes, and obtain necessary signatures from healthcare providers.

What is the purpose of take back your treatment?

The purpose of Take Back Your Treatment is to enhance patient autonomy regarding their healthcare decisions and ensure their preferences are respected in the treatment process.

What information must be reported on take back your treatment?

The information typically required includes the patient's identification details, current treatment being received, desired changes, and supporting medical documentation.

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