Book an appointment Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Parent/Guardian Full Name *Child/Patient Full Name *GenderMaleFemalePrefer Not to SayEmail Address * Visit Contact Date Preferred Contact Method *Phone CallEmailText MessageSelect DoctorDr. Arya Motaghi – Family PhysicianDr. Riken Patel – PediatricianDr. Naveet Sharma – PediatricianDr. Madikiza – PediatricianNo PreferencePreferred Time *Morning (8:00 AM – 12:00 PM)Afternoon (12:00 PM – 4:00 PM)Evening (4:00 PM – 7:00 PM)Reason for Visit *General ConsultationPediatric CheckupVaccinationFever or IllnessGrowth and DevelopmentAllergy ConcernsNutrition ConsultationFollow-Up AppointmentOtherDescribe Symptoms or Additional NotesPrivacy Consent *I agreeI understand that submitting this form does not guarantee an appointment. A member of Markham Kids Clinic will contact me to confirm the appointment details.Request Appointment