Bring identification
Have a valid identification document and current contact details available.
Appointment Requests
Request your visit in just a few minutes.
Tell us how we can help and share your preferred date. Our clinic team will review your request and contact you to confirm the provider, date, and time.
Whole-Family CareChildren, adults, and seniors
Same-Day RequestsReviewed when availability allows
Arabic & EnglishMultilingual patient support
Request an Appointment
Share the essentials. We’ll handle the next step.
This short form is for general appointment requests. Keep your message brief and avoid submitting detailed medical history or sensitive health information.
- Choose the closest visit type
- Provide a preferred appointment date
- Use a phone number and email you monitor
- Wait for confirmation before attending
Prefer to speak with our team?
Call during clinic hours for scheduling assistance or questions about the right visit type.
→Medical emergency?
This form is not monitored for emergencies. Contact your local emergency number or go to the nearest emergency department.
This form is not monitored for emergencies. Contact your local emergency number or go to the nearest emergency department.
Appointment Request
Complete the form below and our team will contact you to confirm availability.
Submitting this form sends an appointment request only—it does not confirm a booking. Please do not include urgent concerns or detailed sensitive medical information.
Before Your Visit
Arrive prepared and feel confident.
Once your appointment is confirmed, our team will explain any preparation specific to your visit. These simple reminders help most appointments run smoothly.
List medications
Bring an up-to-date list of medicines, supplements, and known allergies.
Relevant records
Bring recent test results or referral documents if they relate to your visit.
Prepare questions
Write down your main questions so the visit stays focused on your priorities.
Common Questions
Helpful answers before you request.
Need additional help? Call our clinic team using the Business Profile number below.
Is my appointment confirmed when I submit?
No. The form sends a request. Our team will contact you to confirm the provider, date, and time.
Can I request a same-day visit?
Yes. Same-day requests are reviewed according to clinic capacity and the nature of the concern. Availability is not guaranteed until confirmed.
What should I write in the message field?
Use a brief, non-sensitive description such as “routine checkup,” “follow-up,” or “new symptom.” Do not submit detailed medical records through this general website form.
Can I request a specific provider?
Yes. Mention your preference in the message. If that provider is unavailable, our team can discuss the next appropriate option.
Questions before requesting?
123 Kitchener St, Kitchener ON N2L1W5 ·