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Patient Request for Eye Appointment

Please complete the information below and submit the form online. We will get back to you to book an appointment soon after.

This form contains confidential information and is delivered through a secure Internet connection. The information collected below is safely stored and used to create an accurate patient profile for those who attend the clinic. By clicking submit, you consent to the release of your information to Dundas Optometry Clinic.

Please contact our office by phone at 905-628-5866.

Please contact our office by phone at 905-628-5866 as you may only require a partial eye exam to address your concerns.

Please check off what days and times you would be available for an appointment.