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Canadian Residents Only

If you would like to book a consultation with Dr. Lee and require information beforehand, please complete the form below.

Only questions related to fees and appointments can be answered from this form. We regret we
cannot answer specific questions about your medical condition.

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First Name: *

Last Name: *

Address 1:

Address 2:

City:

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Postal Code: *

Phone: *

Cell Phone:

E-mail: *

Method To Contact Me By:

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Procedure:

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Please tell us which procedure(s) you wish to discuss during your consultation: (hold Control key down while “selecting” to highlight multiple choices):

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Questions / Comments:

We regret we cannot answer specific questions about your medical condition via email. If you have a question about fees or your consultation please ask it below. Only questions related to fees and consultations can be answered from this form. Whether a procedure or treatment is right for you can only be determined by an examination at the time of an office consultation.

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