Confirm Your Appointment

Please call (613) 233-303o to find out about advertising opportunities.

Your Full Name
Your Telephone number
Your appointment date
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Do you have OHIP coverage?
Who is your family doctor?
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Your appointment will be confirmed after you complete and submit this form
* You will receive a reminder 2 weeks before your appointment
** If you wish to cancel or change your appointment please call (613) 233-3030
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