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Located right in the centre of Smithville,
just south of the intersection of Hwy 20 and Griffin St. S.

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Home » Patient Forms » Appointment Request Form

Appointment Request Form

If this is an emergency, do not contact us via email, please use our emergency
contact information
.

Complete the following form:

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. *Please do NOT send private information on this form.*
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
  • :
  • This field is for validation purposes and should be left unchanged.

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Our commitment to creating a safe environment and caring for our patients will continue as we remain open following the directive of our regulating College.

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Stay up to date on our COVID-19 pandemic protocols Read Our Blog Post…

We are gradually opening our office to scheduling exams for our patients. Contact the office to schedule an appointment but please be aware that we have a limited amount of spaces each day. We will do our best to see you in a timely fashion.

Stay COVID safe!