QPILogoPNG W2

Call 514-747-3668

QPILogoPNG W2

  • We accept emergencies

  • No medical reference needed

  • Covered by most private insurance plans

  • Preventive and surgical foot care

  • Treating feet of all ages

  • Save time and fill out paperwork safely and securely online

  • Treating sports injuries, fractures and heel pain

New Patient Forms

2018-New-Patient-form-short.pdfSave time on your first visit by finishing the New Patient Information Form online. You can also print and complete the form and bring it with you to your first visit.
 

Online New Patient Form

Complete the Online New Patient Form and click the "Send" button. The information you entered will be sent to our office electronically and securely.

Click this link to begin: Online New Patient Form

Printable New Patient Form

Print your New Patient form, complete the information by pen, send it by fax or bring it with you to our office..

Instructions: Click on the link below to access the Printable New Patient Form. After you click the link, click on the 'PRINT' icon on your browser. Fill it out and bring it into our office, or you may also fax it to the office.

Click this link to open the form: New Patient Printable Form.*

Office

SAINT-LAURENT, Quebec
Fax: 514-747-2229

*To open the Printable New Patient Form, you will need Adobe Acrobat Reader.