Request Appointment

Please note that this form is for requesting appointments only. Availability will vary and someone from our office will call you to confirm your appointment request. Please do not submit any Protected Health Information.

Time of day you prefer

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Day of the week you prefer


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Full Name(*)
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Email(*)
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Phone(*)
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How did you hear about us?




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Referred by Doctor?
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Referred by ?
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Referred by other ?
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Describe nature of appointment

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I am aware that the services rendered are not covered by OHIP and that the clinic is not able to bill to my private insurance company directly. (*)
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We will be closed on Closed from September 18th through October 1st and November 19th to November 26th.

Toronto Office

781 The Queensway, Unit N
Toronto, ON M8Z 1N4
Phone : (416) 253-6400
Mon
: 9:30am - 5:00pm
Tue
: 9:30am - 5:00pm
Wed
: 1:30pm - 7:00pm
Thu
: 9:30am - 5:00pm
Fri
: Closed
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