Application For Inclusion on Obesity Physician Locator
My Weight - What To Know is a resource for people living with obesity in Canada. As part of our work to encourage people to seek medical attention for weight management, our website provides a searchable physician locator tool that allows individuals to find relevant resources near them.

If you'd like to be considered for inclusion in this locator, please fill out the form below. Please note-- you can fill in your information without having to edit this form. If you have any questions, feel free to send an email to us at xander@myweightwhattoknow.com. Many thanks!
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Physician Name *
Are you a licensed physician? *
Clinic / Practice Name *
Describe your clinic/practice to any prospective patients, and add anything you might like them to know before contacting your clinic (1-3 sentences - optional)
Clinic / Practice Website
Office Address *
Office Address cont. (Suite or Number - optional)
Office City *
Office Postal Code *
Office Province *
Office Phone Number *
Do you offer telemedicine appointments? *
Email address (this will NOT go on the locator-- it is for us to confirm your willingness to be included in the future) *
Other than English, are there any languages you are proficient in that you use to provide care to patients? (French, Spanish, etc.)
 *
Certifications (Check all that apply) *
Required
Do any of your programs have out of pocket costs?
 *
By submitting this form, you are agreeing to be listed on our locator. Thank you!!              
Thank you for participating!
My Weight - What To Know reserves the right to include physicians that we find align with our certification requirements and overall platform objectives.
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