Request an AppointmentPlease fill out the form below or call the office directly at 905-936-5775 Name * First Name Last Name Email * Are you an existing patient? * Yes No Daytime Phone Number * (###) ### #### Appointment Confirmation Method * Phone Email Checkbox * Chiropractic Health Custom Foot Orthotics Body Fat Composition Analysis Preferred Date MM DD YYYY Preferred Time Hour Minute Second AM PM Additional Comments Thank you for contacting us. Your email has been received and we'll be in touch regarding your appointment request shortly.Regards,Dr. Tom Naylor
