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Doctor Note Request

Issued within 2 hours Working hours 9AM-5PM Secure Square payment

Form progress may be saved securely so our team can help if you do not finish this request. Card details are never collected on this form.

Doctor Note Appointment and Information Form

Please fill out your details and appointment information to receive your doctor note promptly.

Important: The doctor note date range must not exceed 7 days. Please mention the dates clearly, for example: January 1 to January 3, 2026.

Patient Details

First Name Last Name Phone Please enter a valid phone number. Format: (000) 000-0000. Email Street Address City State / Province Postal / Zip Code Date of Birth

Doctor Note Details

Reason for Doctor Note 0/150 Doctor note start date Doctor note end date

Important Information

Doctor's notes will be issued within 2 hours after your appointment. Please ensure all information provided is accurate for timely processing. Working hours: 9AM to 5PM.

Doctor Note Request Payment

Doctor Note Service

Total $45.00 CAD

Doctor Note Service

Request and receive your official doctor note after your appointment.

$45.00 CAD

Payment Method

Square secure checkout

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Refund, Cancellation, and Rescheduling Policy

After your visit

If you have visited us online or in-clinic, there is no refund. The visit itself is the service you paid for, and the fee fully covers that consultation once it has taken place.

Refund requests before the visit

For approved refunds before the visit has taken place, $20 will be deducted for administration and payment gateway charges.

Changes or cancellations

To schedule, reschedule, or cancel your appointment, please call 587-442-4898 or email booking@telepluscare.com. Please tell us as early as possible so we can respect our doctors' time.

Missed appointments

Please avoid last-minute cancellations or rescheduling requests. Missed appointments or no-shows without prior notice may result in a $40-$60 fee before rebooking.