To book an appointment please fill out the form below and we will contact you with an appointment within 48-72 hours.

Patient Last Name:

*

Patient First Name:

*

Primary Contact Phone Number:

*

Contact Name:

Date of Birth:

Gender:

Select Male Female

Email:

Health card number:

Preferred time:

8:00am - 12:00pm 12:00pm - 4:00pm 4:00pm - 8:00pm

Preferred day:

Weekday Weekend

Choose a Location:

Select Location 1309 Carling Ave.150 Katimavik Rd.1580 Merivale Rd.1582 Bank St.2016 Ogilvie Rd.225 Preston St.2573 Baseline Rd.2948 Baseline Rd.368 Slater St.

Type of Physical:

MOT Pre-Employment Pension buyback Insurence Travel CAMP General Health Other

I live in:

Ottawa Quebec

Please type:

*

If the text in the image is not entered correctly, you will be required to re-fill the form.