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Appointment Request

This service is for our registered patients only.

To request an appointment with your family doctor or healthcare professional please use the following form. The menus let you be specific about the service you are looking for, and please add any relevant details so we accomodate your request as fully as possible.

While we check email regularly during business hours, sometimes we cannot respond to you right away. We do prioritize emails based on urgency and we will try to respond to your enquiry by the next business day. Please do not use this service for urgent health care concerns as we cannot guarantee that we will see your email immediately. Dial 911 for emergencies.

REASON FOR YOUR APPOINTMENT MUST BE INCLUDED IN YOUR MESSAGE


Name:
Email:
 
Phone Number:
 
Appointment Details:
Provider:
Image/photo:
Photo - to help in handling your request (max 10Mb):
Message:
 



Important information about this service
In using this on-line registration service you accept that you are submitting your name, e-mail, name of your doctor and other details through this website. This information will be used for the sole purpose of tracking and administrating your request.


While we take all reasonable precautions to safeguard your data, you acknowledge that the transmission of data through the Internet and the use of computing devices represent a risk beyond the control of the Family Health Team. We suggest you assume that all data transmitted through this service may be intercepted and analysed by third-parties, and that you only submit information on this understanding.

You acknowledge that this information will be stored electronically, in a secure manner.

You acknowledge that as a result of signing up through this service, you may receive e-mails containing registration information and other healthcare related information from the Family Health Team in the future.