30 Martha Street, Unit 203
Bolton, ON
L7E 5V1
Phone: (905) 857-2773
REQUEST AN APPOINTMENT


You can send us an appointment request by completing the following form. Please note that we cannot guarantee that your requested date and time will be available. One of our staff members will contact you and confirm the appointment.

Hours of Operation

Monday9:00 am- 6:00 pm
Tuesday9:00 am- 6:00 pm
Wednesday9:00 am- 6:00 pm
Thursday9:30 am- 6:00 pm
Friday9:00 am- 6:00 pm
Saturdayclosed
Sundayclosed
*Indicates a required field

I am a new patient
Clinic*
First Name*
Last Name*
Home Phone*
Cell Phone*
Email*
First Preferable Date*
Time of Day*
Second Preferable Date*
Time of Day*
Doctor*
Reason for appointment*
Extra Comments
(if any):





 
 
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