Online appointment

If you need an urgent appointment, please contact us at (514) 594-0208.
You can also make an appointment by using this form. We will confirm the appointment within 48 hours.
_____________________________________________________________________________________

Do you wish to receive confirmation of the appointment by :
Phone Email
Would you like an appointment during :
Morning Afternoon Evening
Which day of the week would you like your appointment?
First name:
**first name is mandatory**
Last name:
**last name is mandatory**
Your address :
City:
Province:
Code postal:
Email:
**email is mandatory****invalide email**
Home phone:
Work phone:
Cell phone:

 

 

 
© 2010 CHIROPRATIQUE ST-LAZARE

Chiropratique St-Lazare
Dr. Eric S. Butz
Téléphone : 450.424.9288
Urgence : 514.594.0208

Création: JoseeStudio