Online Appointment request

To book an appointment it is best to call our office at 416 340-8222.  If we are busy or out we will return your call.  If you are unable to contact us or are outside Canada and want to book and appointment when you return you can email us at appointments@travelclin.com or submit the following form. If you wish to make special arrangements for a large group or appointment outside regular office hours please call or e-mail us.  If you need an appointment within a few days please call.

Please provide the following contact information:  We will contact you by e-mail unless you are in Ontario and indicate you want us to call you

Please contact me by    e-mail    telephone

First Name
Last Name
Work Phone   
Home Phone
E-mail

 Numbers of persons

 

Enter the date that you wish to come in :

First choice          

Second choice     

Third choice         

 

Enter the time of day you prefer. :  morning,   afternoon  or evening  Check more than one if desired

morning (Thursday or Friday)

afternoon (Monday, Tuesday, Thursday)

Evening (Tuesdays)

Please fill in any special request or comments below


Copyright © 1999 [Travel Medicine Centre]. All rights reserved.
Revised: April 15, 2010