Apply My practice is currently full. Please use the form below to add yourself to my waiting list. Name(required) Email(required) Phone number (optional) How did you hear about me? Select one option Referred by another patient Referred by a healthcare provider Instagram Facebook Friend or Family Other If you were referred to my practice, is there an individual I may thank for recommending me? Tell me about your health concerns, goals for treatment, and why you think we would be a good fit: Do you have questions about working with me that were not answered by my website? IMPORTANT! My visits take place by telemedicine only (video or phone) and you must be located in Ontario at the time our our visits in order for me to comply with provincial regulations. Submitting this form does not guarantee a response or an appointment time within any specified timeframe; I will contact you as soon as I am able to onboard new patients. Please only submit this form once. Your information will be kept safe and secure. Kindly indicate that you understand and agree to these terms by entering YES below: Apply Δ Share this:TwitterFacebookLinkedInMorePinterestTumblrRedditLike this:Like Loading...