In order to qualify for the Huntsville Physician and Nurse Practitioner Waitlist you must live within our catchment area. Select Location*HuntsvillePort SydneyUttersonDwightDorsetBaysvilleMelissaNovarPlease register using the form provided below. Please note this is a waitlist only and does not guarantee you will be rostered to a physician. We direct registrations to the physicians and they accept patients into their practices accordingly.Name* First Last Date of Birth* Phone*Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Additional Family MembersNameDate of Birth EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.