Appointment Request

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Patient InformationNote: For Prescription refill request, please have your pharmacy fax us the request instead at 416-546-3657. This does not apply to patients who are on opioid or psychiatric medication. An appointment must be booked for these types of medication.

Patient's First Name

Patient's Last Name

Healthcard Number

Healthcard Version Code

Phone Number

E-MAIL

Select Medical Concern(s)

Details of Medical Concerns

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How would you like us to contact you?We will respond to you with an appointment confirmation within 48 hours. If you have an eye or skin concern related to lump, rash, discolouration, swelling, etc, you must provide a photo by emailing it to us at admin@umedical.ca

Phone

E-mail

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Appointment Preference - Click SUBMIT once finished.YOU MAY ONLY REQUEST AN APPOINTMENT WITH YOUR FAMILY DOCTOR. Your appointment is only confirmed if one of our administrative staff reaches out to you. We will always book you in the next available, closest to your preferred date and time. Please note that we try to prioritize evening hours for same day bookings/urgent appointments.