Video Consultation Form

You must speak to one of our Patient Coordinators before filling this out.

Step 1

Please Answer All Of The Questions Below

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Call one of our Patient Coordinators at (204) 813-0305 to reserve your Video Consultation.


Step 2

Step 3

Step 4

Once you have a Video Consultation date, you can fill out the form below. All questions must be answered.

Click “send”. The form will be reviewed by Dr. Avi Islur and his Surgical Coordinator prior to your Video Consultation.

Dr. Avi Islur will call you at the time of your consultation. Please note that it may take 10 to 15 minutes from your consultation time for Dr. Avi Islur to call. This will only happen if consults are running behind.