Appointment Request Page

Name: Eyes on Sheppard
Address: 180 Sheppard Ave East, Toronto, ON, M2N 3A4, CA
Telephone: (416) 733-4444
Price range: $000 - $300

If this is an Ocular Emergency, please call us at 416-733-4444 or go to the nearest Emergency Center if it is after hours. This online scheduling form is for regular eye appointments only.

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*
Date of Birth*
Date Format: MM slash DD slash YYYY
Email*
Best Time to be Reached for Confirmation*

: HH

MM
Comments
Comments
This field is for validation purposes and should be left unchanged.

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