Appointment Request

How to Schedule an Appointment

1. Contact our office by phone or complete the appointment request form below.

2. If you would like to schedule a new appointment, please tell us what you want an appointment for in the Reason For Visit section

3. To set up a consultation to learn more about one of our services, please specify the service you are interested in Reason For Visit section.

4. Sit back, relax we’ll contact you!

In a Hurry? Text Us! 905-313-1003

Please do not use this form to cancel or change an existing appointment.

Patient Information

Name

Phone

Are you a current patient?YesNo

Patient Availability

Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Reason For Visit

Please describe the nature of your appointment?

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.