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Ajax Harwood Clinic · Patient Access

How Can We Help You Today?

Tell us what's on your mind and we'll make sure the right person gets back to you. This takes about 2 minutes.

🚨 In a medical emergency, call 911 or go to your nearest emergency department (Lakeridge Health Ajax-Pickering, 580 Harwood Ave S). This form is for non-urgent concerns only and is reviewed within 1 business day. To reach the clinic by phone: 905-683-0690.

Select Concern

A Few Questions

Your Details

Step 1 of 3

What brings you in today?

Select the option that best describes your concern. If you're not sure, choose the closest one — we'll sort out the details.

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New symptom or health concern

Something new that needs to be assessed

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Prescription renewal

Medications that need to be refilled

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✓

Test results or specialist report

Lab work, imaging, or follow-up results

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✓

Form or letter needed

Insurance, sick note, WSIB, driver's medical

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Managing an ongoing condition

Diabetes, blood pressure, asthma, and more

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Mental health support

Anxiety, sleep, stress, group sessions

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Travel medicine

Vaccines, yellow fever, malaria prevention

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Something else

Tell us what's on your mind

← Back

Step 2 of 3

A few quick questions

This helps us prioritize your care correctly.

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Step 3 of 3

Your Details

Almost done. We just need a way to reach you.

Who is your family doctor at Ajax Harwood Clinic?

Dr. Carlos Yu Dr. Maria Yu Dr. Ian Watson Dr. Vivian Lo Not sure / new patient

Full Name *

Date of Birth *

Best Phone Number * 📞 We will call this number — please double-check it before submitting.

Email Address * ✉️ We will send you a confirmation with your reference number.

OHIP Number (optional)

Brief Description of Your Concern 💬 Even one or two sentences helps us route your concern correctly.

A note about appointments: if you can't attend an appointment with us or a specialist, please tell that office as early as you can. Missed appointments delay your care, the specialist may charge a no-show fee, and a referral that has to be redone is an administrative service OHIP does not cover, so a fee may apply. If something is making it hard to attend, please tell us — we'll help.