Appointment form

To make an appointment, call 506-387-2000 or follow the procedure below :

To make an appointment on line :

  • Choose the day and time that are convenient to you
  • Give us your complete contact information
  • Fill out the form to open a medical file if this is your first visit

We will call or e-mail you within 24 hours to confirm your appointment or offer you another date and time.

Make an Appointment

Appointment date:

Month:    Day:    Year:
Preferred time of day for appointment : 

Please confirm my appointment by : *

(telephone) home
(telephone) home
Comments, questions?

Personal information

First name : *
Last name : *
Gender : F    M
Age :
Address :
City :  
Postal code :
Telephone : *
E-mail : *


Thank you for taking the time to complete this form. We are looking forward to meeting you.

200 Champlain street, Suite 240, Dieppe, Nouveau Brunswick, Canada - Tel.: 506-387-2000