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5 Swan Lake Blvd, Unit 7
Markham, ON L6E 0K7

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Home » Contact Us » Appointment Request Form

Appointment Request Form

If you are new to our clinic, please follow this link to schedule an appointment with us. COVID-19 / Appointment Procedure

If this is an emergency, do not contact us via email, please use our emergency contact information.

For existing patients to schedule your next appointment, please complete the form below and let us know the most convenient time and date for you. Please don’t forget to include accurate contact details so we can follow up with you to finalize your request.

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
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    Please let us know if you are a new or existing patient.
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  • Electronic Communication Consent

    In order for us to provide access to complete forms online, email receipts, and receive appointment reminders, and necessary communication content for your eye care services.
  • You can withdraw your consent to receive Electronic Communications at any time by contacting Markham Eye and Vision Care, Dr. Yilei Wang, Optometrist.
  • This field is for validation purposes and should be left unchanged.