Please print and complete this form and return it by mail, fax (807-475-9797) or email to info@lnplc.ca. Due to a large number of applications to our clinic, we quickly reached patient capacity and began forming a wait list. If you have submitted your application, it will be kept on file and you will be contacted in the future should openings become available or additional staff are hired. Should you locate primary health care through a different provider, please let us know so your spot on our list can be opened to another patient in need.