Medical Advice Request Form

The medical advice request is intended for non-urgent questions as calls will be returned within 1-2 business days, typically at the end of the day. The request will be returned by telephone, not by email.
If the problem is urgent, then please attend one of our daily walk-in sick visit clinics, or to the nearest Emergency Room

Patients-child's Name:
Parent's Name:
Home Telephone #:
Daytime Contact #:
Evening Contact #:
For which physician:
Briefly state the nature of your question/problem:
Verification code, please enter it
For security, please input the number above:


Weekly Schedules Request or Confirm Appointments Contact Details Request Medical Advice