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"Thank you for contacting LivingHope Vision Clinic. Please select the day (Tuesday–Saturday) and time (AM or PM) you would like to book your appointment. Let us know how you prefer to be contacted (call or text), and if by call, when is the best time to reach you."

Patient Registration Form
Please fill in the form below.

I am booking appointment at...
Mobile (Cell Phone)?
Mobile (Cell Phone)?

Health Card/Information

(if you don't have OHIP card, please call our office to book an appointment )

Health Card Sample LivingHope Vision Clinic BURLINGTON•HAMILTON
Do you need new eye glasses?
Are you are a contact lens wearer?
I give consent to LivingHope Vision Clinic to contact me regarding my medical reports, my vision/ocular health using the contact information I have provided for personal communication.

Appointment & Communication Preferences:

Preferred Appointment Day:
02:30 PM
Preferred Contact Method:
Best Time to Reach You (for calls):

Thanks for submitting!One of our staff members will contact you shortly.

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