Appointment Request Form

To book an appointment, please contact our receptionist, Colleen, during regular office hours at 519-886-3937

OFFICE HOURS:

Monday, Thursday, Friday – 8:30am to 5pm
Tuesday and Wednesday – 8:30am to 8pm

If you are unable to make it to a scheduled appointment, please kindly give us 24 hours notice.

Please arrive 10 minutes prior to your scheduled appointment and bring with you any glasses or contact lenses you have been wearing, and your up-to-date OHIP information. You may receive eye drops during your examination that will make your eyes sensitive to light. A pair of sunglasses is recommended.

Please fill in the form below to setup an appointment.
Reason for Appointment
Please provide a reason for your appointment. Details are stored securely and not sent by email.
Preferred Date & Times*
Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
Patient Type*
- New patient
- Returning patient
Please let us know if you are a new or existing patient.
Name*
First Last
Phone*
Email*
Best Time to be Reached for Confirmation*

: HH

MM
Comments
Name
This field is for validation purposes and should be left unchanged.

Appointment Request Form

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