Appointment Request Form

Please fill in the form below to setup an appointment.
Reason for Appointment
Please provide a reason for your appointment. Details are stored securely and not sent by email.
Preferred Date & Times*
Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
Patient Type*
- New patient
- Returning patient
Please let us know if you are a new or existing patient.
Name*
First Last
Phone*
Email*
Best Time to be Reached for Confirmation*

: Hours

Minutes

AM/PM
Comments
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Email
This field is for validation purposes and should be left unchanged.

Now accepting new patients!

We are OPEN by APPOINTMENT ONLY. Please call (905) 898-2251 or email staff@bridgeoptometry.ca to book an appointment. Click here for more information on the changes we have made to provide a safe environment for our patients, staff, and doctors.

Chalaturnyk Bridge Optometric Group