Appointment Scheduler

To schedule an appointment, please fill out the information below and press the submit button.  The information will be sent to our office by email, and we will reply to confirm the appointment. Include a day-time phone number where we can reach you, and e-mail if convenient. PLEASE NOTE, USING THIS ON-LINE FORM DOES NOT GUARANTEE AN APPOINTMENT. 

If you would like to be put on our short-notice call list in case we have cancellations, please check the appropriate box.

If you have an emergency, please contact the office directly at 613-546-9898.


PLEASE NOTE: Submitting this form does NOT confirm your appointment. You will be contacted by a member of our office to confirm your appointment date and time.


Patient's Name:
Email Address:
Phone Number:
Reason for Appointment:

 Check here to be on our Short Notice Call List 


      

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