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.

Once your form is complete, click “Send”. Your Video Consultation Form will be automatically sent to Dr. Avi Islur and will be reviewed prior to your consultation date.

Dr. Avi Islur and his Surgical Coordinator 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.