Request an Appointment

New Patients Are Always Welcome!

You can use the form below to request an appointment.

If your request is an emergency or requires immediate attention, please contact our office directly at (905) 508-5568.
Your Name:*

Email Address:*
Phone Number:*

* Required Fields
Are you a new or returning patient?
New Patient
Returning Patient
Choose the days of the week that you are available:
Monday
Tuesday
Wednesday
Thursday
Choose a preferred time:
Reason for appointment:
What is the best way to contact you to confirm your appointment?
Please email me
Please call me