Virtual Appointment

please fill out this form

Step 0 of 3 - Appointment Consent

Daniel Medical Centre Virtual Appointment Consent Form

Last Updated: October 2025

Welcome to Daniel Medical Centre�s Virtual Appointment booking system. Before proceeding, please review and confirm the following terms and conditions. These are required under Ontario regulations for virtual care.

Services: Our virtual appointments provide access to non-emergency primary care, wellness, and counseling services through secure telemedicine technology.

Privacy: Daniel Medical Centre complies with the Personal Health Information Protection Act (PHIPA) and other applicable privacy laws. For questions about privacy, contact [email protected].

Consent: By agreeing to this form you understand and agree to:

Daniel Medical Centre�s Terms of Use and Privacy Policy.
The risks and limitations of telemedicine, including technological limitations.
Your consent remains valid for the duration of your use of our virtual services.

Alternative Booking Method

If you would prefer to book by phone, please call us:

Daniel Medical Centre: (905) 574-3000

Or if you would like to book an in-person appointment, you can now do so online:

Book In-person Appointment: (Appointment Button)

Important: Please do not book more than one appointment for the same health care provider in the same day. If you do, all your appointments will be cancelled for that day.

Please enter information below

Step 1 of 3 - Appointment Information

Note: Earliest availability Virtual Appointment is tomorrow at 1PM

Do you have an Ontario Health Card? *

I have a health card

No health card (Private insurance/pay)

Date of Birth *

Full Name *

Email Address *

Phone Number *

Are you an existing patient of Daniel Medical Centre? *

Yes, I'm an existing patient

No, I'm a new patient

I accept the Daniel Medical Centre and Privacy Policy agreements. *

Remember my info (for 30 days)

Looking for a different medical service? Click here to change service.

Please select your preferred appointment details

Step 2 of 3 - Appointment Scheduling

Note: Earliest availability Virtual Appointment is tomorrow at 1PM

Select Your Doctor *

Dr. Ayman Soliman - Family Medicine Physician

Dr. Meriam Basta - Family Medicine Physician

Preferred Date *

Please select your preferred date for the virtual appointment

Preferred Time Slot *

Morning (9:00 AM - 12:00 PM)

Afternoon (12:00 PM - 5:00 PM)

Evening (5:00 PM - 8:00 PM)

Reason for Visit *

Additional Notes (Optional)

Quick Links

Virtual Appointment

Daniel Medical Centre Virtual Appointment Consent Form

Alternative Booking Method