NEW PATIENT INTAKE FORM

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Dr. Robert Dydynsky

Dr. Robert Dydynsky is a Family Medicine Physician now practicing in his hometown of Etobicoke at The Borough Health & Wellness. He offers comprehensive care with a focus on preventative health, chronic disease management, joint injections, and urgent care.

His services include physical exams, mental health support, management of chronic conditions like diabetes and asthma, treatment for injuries and acute illness, travel vaccines, and therapeutic joint injections for pain and inflammation.

If you’re interested in becoming a patient of Dr. Robert Dydynsky, please complete the form below to book a meet and greet. We’ll be in touch to confirm your appointment.

Welcome to The Borough Health & Wellness!

Help Dr. Dydynsky prepare for your visit by completing this short mandatory intake form.

First Name *

Last Name *

Date of birth *

Phone *

Email *

Full Address *

Preferred Pharmacy *

Health card number (including the last two letters): *

Emergency Contact Name *

Emergency Contact Phone *

Emergency Contact Email *

Do you need your past medical records transferred from your previous doctor? *

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Tell Us Anything Else *

I’m open to receiving supportive updates and information that can help me better understand my symptoms and the wellness options available to me. I can unsubscribe at any time. *

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For clinic use only. Your responses are confidential and help our team at The Borough provide care that’s tailored to your wellness needs.