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Patient Area

Q: Copy of the results of the tests done at Physimed

[gravityform id="18" title="false" description="false" ajax="true"]

Q: Copy of the results of tests done elsewhere

[gravityform id="50" title="false" description="false" ajax="true"]

Q: Partial copy of the file

[gravityform id="47" title="false" description="false"]

Q: Complete copy of the file

[gravityform id="44" title="false" description="false"]

Q: Copy of a lost requisition

[gravityform id="52" title="false" description="false" ajax="true"]

Q: Request for an appointment - Medical check-up

[gravityform id="71" title="false" description="false" ajax="true"]

Patients Area

Now available!

Send us your request online via our Website!

We are proud to provide you with a new “Patient Area” in order to optimize our customer service and facilitate certain requests for services submitted by our patients (renewal of medications, copy of files, completion of forms by the doctor, etc.) as well as booking an appointment online.

the patient area is not working. Please call 514-747-88888 ext. 4262 to request a prescription renewal without a visit to your family physician or to complete a form. To request a copy of your file call 514-747-8888 ext. 4251.

Online requests services

Request for a copy of results, copy of files, lost requisition, medication renewal, completion of form, etc.

Click here

Online request for an appointment

Travel Health Clinic, Pediatric and Adult Vaccination, Medical check-up, Consultation in medical specialties, etc.

Click here

ONLINE REQUESTS SERVICES

From now on, there is no need anymore to call or leave a message on a voice mail to get your services!

You can place your requests directly online and you will receive your documents in a secured and fast way.

We strongly encourage you to use this new online service via our website which will save you time and unnecessary travel, and increase efficiency and speed of services!

Please remember to check your ”spam” or ”junk” folder if you do not receive a response from us within the specified delays.

Patients_Area_requests

Copy of the results of the tests done at Physimed

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Please note that the imaging service is available at RADIMED.Please contact RADIMED at 514 747-8192 for copies of imaging results (radiography, echography, MRI, etc.).
Hidden
Have you done your exams at Physimed?
- YES, I did my exams at Physimed
- NO, I did my exams elsewhere
If you have done the tests or exams at our center, we will be happy to send you the results requested within 72 working hours.

Please complete the following questionnaire:

Please remember to check your ''spam'' or ''junk'' folder if you do not receive a response from us within 72 business hours
Identification*
First Last
Email*
Enter Email Confirm Email
Phone*
Birth date*
YYYY slash MM slash DD
Health Insurance Number (RAMQ)*
(no spaces)
Which result you would like to have a copy of?*
- Laboratory Test (blood tests, urinalysis)
- Electrocardiogram (ECG)
- Holter
- 24-Hour Blood Pressure Monitor
- Electromyogram (EMG)
- Hearing Test
- Spirometry Test (pulmonary function)
- Other
Please specify*
When did you get the tests done? (approximate date)*
YYYY slash MM slash DD
You will receive the requested document through a secured email. The document will be available for 5 days before it expires. You will need to enter the password you choose in order to access it.
Please choose a password to receive the document through a secured email*
(You will receive a copy of your results via a highly secured email for which you will need to enter the password you chose in order to access it)
Certificate*
- I hereby certify that I am the person who has undergone the tests or examinations requested
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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Copy of the results of tests done elsewhere

.ginput_price { display: none; }
You need to contact the establishment where you conducted the tests or exams to obtain a copy of the results.
If you would like us to handle your request, we will be pleased to provide you with a copy of your results, however administrative fees will apply.

Please note that we do not make any calls to other centers to ask them to send out results. You must contact the center where you did the tests or exams to make sure they have sent them to us. We will send you your results once we have received them from the center where you performed the tests or exams.

Once your request below is completed, we will be happy to process your request.

Copies of test results is not a service covered by Medicare. Therefore, fees apply, based on the Federation of Physicians' fee scale.

Please remember to check your ''spam'' or ''junk'' folder if you do not receive a response from us within 72 business hours.
Identification*
First Last
Email*
Email Confirm Email
Phone*
Other phone number
Date of birth*
YYYY slash MM slash DD
Health Insurance Number (RAMQ)*
(No space)
Name of the requesting physician*
Name of the institution where you took the test
Which result would you like to have a copy of?*
- Radiology/Imaging Test (Xrays, ultrasounds, MRI)
- Laboratory Test (blood tests, urinalysis)
- Electrocardiogram (ECG)
- Holter
- Pathology
- Electromyogram (EMG)
- Other
Please specify*
When did you get the tests done? (Approximate date)*
YYYY slash MM slash DD
Fee for request of a copy of the test results done elsewhere
Price:
Transmission mode*
- I will pick up the documents at the clinic once you notify me that it is ready (fee for the completion of the request only)
- Highly secure email (fee for the completion of the request + $20)
- Mail (fee for the completion of the request + $20)
GST
Price: $ 0.00 CAD
QST
Price: $ 0.00 CAD
Total
$ 0.00 CAD
Please choose a password to receive your file through a secure email*
(You will receive a copy of your test results via a highly secure email. You will need to enter the password you chose in order to access your file.)
Address*
Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code
Confidential document transmission agreement*
- I hereby certify that I am the person identified in this request and I consent to receive my request for this service, as formulated.
Credit Card
Card Details
Cardholder Name
Secure payment via PayPal
After clicking the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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Partial copy of the file

Once your request below is completed, we will be happy to respond to your request within 15 business days.

The partial copy of the file is not a service covered by Medicare. Therefore, fees apply, based on the Federation of Physicians' fee scale.

Please remember to check your ''spam'' or ''junk'' folder if you do not receive a response from us within 15 business days.
Identification*
First Last
Email*
Email Confirm Email
Phone*
Date of birth*
YYYY slash MM slash DD
Health Insurance Number (RAMQ)*
(No spaces)
Which documents in your file would you like a copy of?*
Fee for partial copy of the file
Price:
Transmission mode*

I will pick up the documents at the clinic once you notify me that it is ready (fee for the completion of the request only)

Highly secure email (fee for the completion of the request + $20)

Mail (fee for the completion of the request + $20)
GST
Price: $ 0.00 CAD
QST
Price: $ 0.00 CAD
Total
$ 0.00 CAD
Please choose a password to receive your file through a secure email*
(You will receive a copy of your documents via a highly secure email. You will need to enter the password you chose in order to access your file.)
Address*
Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code
Confidential document transmission agreement*
I hereby certify that I am the person identified in this request and I consent to receive my request for this service, as formulated.
Payment

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name
Secure payment via PayPal
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

g

Complete copy of the file

.ginput_price { display: none; }
Once you complete the request, we will be happy to respond to it within 15 business days.

The complete copy of the file is not a service covered by Medicare. Therefore, fees apply, based on the Federation of Physicians' fee scale.

Please remember to check your ''spam'' or ''junk'' folder if you do not receive a response from us within 15 business days.
Identification*
First Last
Email*
Email Confirm Email
Phone*
Date of birth*
YYYY slash MM slash DD
Health Insurance Number (RAMQ)*
(No space)
Fee for complete copy of the file
Price:
Transmission mode*

I will pick up the documents at the clinic once you notify me that it is ready (fee for the completion of the request only)

Highly secure email (fee for the completion of the request + $20)

Mail (fee for the completion of the request + $30)
GST
Price: $ 0.00 CAD
QST
Price: $ 0.00 CAD
Total
$ 0.00 CAD
Please choose a password to receive your file through a secure email*
(You will receive a copy of your documents via a highly secure email. You will need to enter the password you chose in order to access your file.)
Address*
Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code
Confidential document transmission agreement*
I hereby certify that I am the person identified in this request and I consent to receive my request for this service, as formulated.
Payment

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name
Secure payment via PayPal
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

g

Copy of a lost requisition

Once your request below is completed, we will be happy to respond to your request within 15 business days if your doctor is not absent (on vacation, congress or other).

The copy of a lost requisition is not a service covered by Medicare. Therefore, fees apply, based on the Federation of Physicians' fee scale.

Please remember to check your ''spam'' or ''junk'' folder if you do not receive a response from us within 15 business days.
Identification*
First Last
Email*
Enter email Confirm Email
Phone*
Date of birth*
YYYY slash MM slash DD
Health Insurance Number (RAMQ)*
(No space)
Which request would you like a copy of?*
What is the name of the doctor who issued the request?*
Approximate date of issuance of the request*
MM slash DD slash YYYY
Fee for a copy of a lost request
Price:
Transmission mode*

I will pick up the documents at the clinic once you notify me that it is ready (fee for the completion of the request only)

Highly secure email (fee for the completion of the request + $20)

Mail (fee for the completion of the request + $20)
GST
Price: $ 0.00 CAD
QST
Price: $ 0.00 CAD
Total
$ 0.00 CAD
Please choose a password to receive your file through a secure email*
(You will receive a copy of your request via a highly secure email. You will need to enter the password you chose in order to access your file.)
Address*
Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code
Confidential document transmission agreement*
I hereby certify that I am the person identified in this request and I consent to receive my request for this service, as formulated.
Payment

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name
Secure payment via PayPal
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Medication renewal

To request an online renewal of your medications, you must complete the request below and we will be pleased to respond to your request rapidly if your doctor is not absent (on vacation, congress or other).

No request for renewal of medication will be processed if you have not seen your doctor within the past year. If necessary, your doctor may ask to see you in consultation before renewing your medication.

The online renewal of medications is not a service covered by Medicare. Therefore, fees apply based on the Federation of Physicians' fee scale.

Once this request is completed, please contact your pharmacist to send us the list of medication to renew by fax at 514 747-4705.
Identification*
First Last
Email*
Email Confirm Email

Phone*
Date of birth*
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(No space)

Name of the doctor who needs to renew your medication*

Fee for medication renewal
Price:
Transmission mode*

I will pick up the documents at the clinic once you notify me that it is ready (fee for the completion of the request only)

Highly secure email (fee for the completion of the request + $20)

Fax to my pharmacist (fee for the completion of the request + 20$)
GST
Price: $ 0.00 CAD
QST
Price: $ 0.00 CAD
Total
$ 0.00 CAD
Please choose a password to receive your file through a secure email*
(You will receive a copy of your documents via a highly secure email. You will need to enter the password you chose in order to access your file.)

Fax number of your pharmacist*
Confidential document transmission agreement*
I hereby certify that I am the person identified in this request and I agree to receive my request for this service, as formulated.
Payment

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name
Secure payment via PayPal
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Completion of form

.ginput_price { display: none; }
To request an online completion of a form by your doctor, you must complete the information below and attach the form to be completed. Completion of a form is not a service covered by Medicare. Therefore, fees apply, based on the Federation of Physicians' fee scale. These fees vary according to the type of form to be completed. If you have more than one form to complete, you must make a separate request for each of them.

Before sending us your request, please make sure that :

You have completed the Patient’s Authorization and/or Patient’s Identification section of your from

You have signed the form in the required place

You have indicated on the form the starting date of your disability/absence/accident (SAAQ) or other

Please note that following the review of your medical record, your doctor may ask to see you in order to complete your form. In this case, we will contact you to schedule an appointment.

Once you have filled out the request below and you have uploaded your form to be completed by your doctor, we will be happy to process your request within 15 business days if your doctor is not absent (on vacation, congress or other).

Please remember to check your ''spam'' or ''junk'' folder if you do not receive a response from us within 15 business days.
Identification*
First Last
Email*
Email Confirm Email

Phone*
Date of birth*
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(No space)

What is the name of the doctor who needs to complete your form?*

Among the choices below, choose the form that your doctor needs to complete*
Choose your form...Disability Insurance (with the insurance company form) 95 $SAAQ : Permits renewal 95 $SAAQ : Request for parking tag for disabled persons 60 $SAAQ : Initial Report 40 $SAAQ : Medical Evaluation Report 125 $SAAQ : Medical Evolution Report 125 $SAAQ : Medical Report of the sequelae 125 $PROVINCIAL tax credits for disabled persons 80 $FEDERAL tax credits for disabled persons 80 $Request for adapted transport (Société de transport de Montréal) 60 $Certificate of Good Health (camp, schools, travel abroad, etc.) 60 $Certificate of absence from work (with Physimed's form) 25 $Other 85 $
Transmission mode of the form to be completed by the physician*

By uploading the digital copy of the form

By mail

By fax
Upload your form here
Accepted file types: pdf, jpg, png, doc, docx, Max. file size: 32 MB.
.ginput_price { display: none; }
Please send us your form by mail to the following address:

Attention: Physimed - Patient Services
6363 Trans-Canada, Ville Saint-Laurent, suite 212
Qc. H4T 1Z9
.ginput_price { display: none; }
Please fax us your form to the following fax number: 514 747-8184
Transmission mode of the form once completed by the physician*

I will pick up the documents at the clinic once you notify me that it is ready (fee for the completion of the request only)

Highly secure email (fee for the completion of the request + $20)

Mail (fee for the completion of the request + $20)
GST
Price: $ 0.00 CAD
QST
Price: $ 0.00 CAD
Total
$ 0.00 CAD
Please choose a password to receive your file through a secure email*
(You will receive a copy of your documents via a highly secure email. You will need to enter the password you chose in order to access your file.)

Address*
Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code

Confidential document transmission agreement*
I hereby certify that I am the person identified in this request and I consent to receive my request for this service, as formulated.
Payment

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name
Secure payment via PayPal
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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ONLINE REQUEST FOR AN APPOINTMENT

Patients_Area_rdv

g

Laboratory Tests

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.

In order to better serve you, you can execute your blood and/or urine tests from 6:30 am Monday to Friday and from 9:30 am on Saturdays and Sundays (16 years old and older). Your specimens will be analyzed within 24 to 72 business hours and the results will be sent to your doctor.

The costs for blood and urine analyses are not covered by Medicare, but private insurance companies reimburse, in general, the costs for these services.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without space)

Do you already have a medical file at Physimed?*

Yes

No
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
.ginput_price { display: none; }
Optional : In order to speed up the processing of your request, you can upload in the section below the document of your laboratory request (by taking a photo or scanning it).
File
Max. file size: 32 MB.
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Request for an appointment – Medical check-up

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without space)

Do you already have a medical file at Physimed?*

Yes

No
Are you registered with a family doctor Physimed?*

Yes

No
What is the name of your doctor?*

Please note that appointments for patients who wish to perform their laboratory tests at Physimed are reserved early in the morning to accommodate those patients who must be fasting. For patients who wish to perform their laboratory tests outside of Physimed, appointments are reserved in the afternoon.

The costs for blood and urine analyses are not covered by Medicare, but private insurance companies reimburse, in general, the costs for these services.
If laboratory tests (blood and/or urine analyses) are prescribed by the physician, do you wish to perform them at Physimed at the same time as your medical check-up?*

Yes

No
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
Which morning(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Walk-in clinic

To reserve your spot at our walk-in clinic, click on the image below

Visit our FAQ section to learn more about this servivce.

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g

Travel Health Clinic

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.

The costs for travel health vaccination are not covered by Medicare, but private insurance companies reimburse, in general, the costs for these services.

Learn more about this service by visiting our FAQ section.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without space)

Do you already have a medical file at Physimed?*

Yes

No
Type of consultation*

Individual (1 traveller)

Couple (2 travellers)

Family (2 adults + 1-2 children)

Other
First destination*
Choose...AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCabo VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEast Timor (see Timor-Leste)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe
Second destination
Choose...AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCabo VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEast Timor (see Timor-Leste)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe
Third destination
Choose...AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCabo VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEast Timor (see Timor-Leste)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe
Departure date*
(if you don't know yet, choose an approximate date)
MM slash DD slash YYYY

Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Regular Vaccination for Adults

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.

Learn more about this service by visiting our FAQ section.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without space)

Do you already have a medical file at Physimed?*

Yes

No
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
Which of the following statements describes you best?*

I want to consult for an update of my vaccination profile

I want to receive a specific vaccine

I want to receive a booster dose of a vaccine
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Regular Vaccination for Children

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.

Learn more about this service by visiting our FAQ section.
Identification of your child*
First name Last name
Parent's or Legal Guardian's Email*
Enter Email Confirm Email

Parent's or Legal Guardian's cell phone*
Phone (other)
Date of birth of your child*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without space)

Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
Is your child already being followed at Physimed for vaccination?*

Yes

No
Consent*
I hereby certify that I am the Parent or Legal Guardian of the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Nursing Care

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without space)

Do you already have a medical file at Physimed?*

Yes

No
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
For what reason do you want to see a nurse?*

Wound care

Bandage

Ear cleaning

Injection of allergens

Other
Please specify

Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Specialty Medicine

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.

Please note that for any new consultation request for a consultation with a specialist, you must have a request from your doctor.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without space)

Do you already have a medical file at Physimed?*

Yes

No
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
In which of the following specialties do you want to get an appointment?*

Cardiology

General Surgery

Gynecology

Internal Medicine

Neurology

ENT (Ear-Nose-Throat)

Urology
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

g

Consultation with a psychologist

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without space)

Do you already have a medical file at Physimed?*

Yes

No
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

g

Consultation with a dietitian

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)*
(without spaces)

Do you already have a medical file at Physimed?*

Yes

No
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

g

Consultation in physio/masso/occupational therapy/osteopathy – Kinatex

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 hours to schedule your appointment.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

Health Insurance Number (RAMQ)
(without space)

Do you already have a medical file at Physimed?*

Yes

No
With which specialist would you like a consultation with?*

Physiotherapist

Occupational therapist

Massotherapist

Osteopath
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment
After clicking on the ''submit'' button, please do not exit this page before being redirected to the confirmation page.

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g

Podiatry – Quebec Podiatric Institute

.ginput_price { display: none; }
Once you fill out the form below, we will contact you within 24 business hours to schedule your appointment.

Please note that podiatry services are not covered by RAMQ.
Identification*
First name Last name (at birth)
Email*
Enter Email Confirm Email

Cell phone*
Phone (other)
Date of birth*
(select a date)
YYYY slash MM slash DD

How would like to be contacted*

By phone

By email
Which day(s) are best suited for your appointment?*
Monday
Tuesday
Wednesday
Thursday
Friday
In the morning or afternoon?*

Morning

Afternoon
Consent*
I hereby certify that I am the person identified in this request and consent to be contacted by a Physimed team member to schedule an appointment

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Send us an email

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Phone *
Email *
Subject *
Message *

To contact us

PHYSIMED MEDICAL CENTRE 6363, Transcanada Highway
Saint-Laurent (Quebec)
H4T 1Z9

514 747-8888
Fax : 514 747-0655
[email protected]

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