CMIE Membership

If you need an emergency appointment,
contact us by phone at (450) 332-2430.

CMIE registration form

This form allows you to register with CMIE and a member of our team will contact you to open your patient file, subject to applicable registration fees.

This field is for validation purposes and should be left unchanged.

Next Steps: Install the User Registration Add-On

Ce formulaire d’inscription permet à l’équipe du CMIE de vous contacter afin d’ouvrir votre dossier patient. Les formulaires d’adhésion et de consentements vous seront acheminer via le Portail Patient sécurisé et confidentiel du CMIE.
Name(Required)
Gender(Required)
Email address(Required)
Postal address(Required)
Requested service(s)(Required)
Check all applicables services you would like to obtain at CMIE.

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