Request an Appointment

Please complete this form to check availability for the date and time of appointment you desire. We will contact you within 24 hours to confirm or discuss alternate appointment dates or times. Please note that reservation requests made online or via email cannot be accommodated automatically. In order to fulfill your request, we need to verify availability.

If you require a faster response please call us at 416.486.4776 (HPSM).

* (Denotes required field)

First Name: *

Last Name: *

Your Email: *

Phone Number: *

Preferred Date: *

Alternate Date:

Preferred Start Time: *
:
Service Requested: *

Preferred Health Care Practitioner:

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