Each of us is unique. To best address your needs and concerns we recommend you book a consultation with Dr. Waldron. The best way to do this via this webpage. If necessary this can also be done over the phone (613 544-0200).

Once you have booked a consultation we would like to send you some more information. It is very important that you read this information over and complete the medical forms before coming to the consultation appointment as it will help you get more from your visit with us.

How to book a consultation

If you wish you may also book the treatment for the same day as the consultation. To do this just select the “Consultation and Treatment at the same appointment” from the type of appointment menu below.

Options to Book a consultation Appointment

You may complete the consultation appointment form below and email it to us. A confirmation email will be sent out within 2-3 business days. This method is highly preferred.
You may call us any time at (613) 544-0200. If you wish to leave us a message please tell us when it is convenient for us to call you back.
You may visit us at our office. Please click on “Location Map” to help you find us.

Book a Consultation Request Form (Please complete ALL sections that apply to you in as much detail as possible. This information is very important for our Physician to assist in determining what treatments are suitable for your needs.)

First Name:
Last Name:
Date of Birth:	[Format: DD/MM/YYYY]
Address:
City:
Province:
Postal:	[Format: X9X 9X9]
Home Phone:
Business Phone:
Fax:
Email:	(Required)
Appointment Day and Time Preference: (Please give three preferences)
Preference 1:
Preference 2:
Preference 3:

Area of Interest:	(Select All that Apply - Hold "Ctrl" key and click to add or remove a selection)
What kind of appointment are you interested in booking:
Have you ever had any cosmetic treatments before? Yes. No.
	If you answered yes to the above, please provide as much detail as you can. For example what treatment(s) did you have? When was it done? Where on your body was it done? Were you happy with the results? If not why? Which Doctor did it?"
Do you have any ongoing medical problems? Yes. No.
	If you answered yes to the above, please provide as much detail as you can. For example what medical problems do you have? When did they begin? Is it currently under control? Who is your regular family doctor?
Do you take any regular medications? Yes. No.
	If you answered yes to the above, please provide as much detail as you can. For example what medications do you take? For how long? why do you take them? Has the dosage changed in the last 4 weeks? Who is your regular family doctor?
Do you have any allergies? Yes. No.
	If you answered yes to the above, please provide as much detail as you can. For example what allergies do you have? How do they affect you?
Do you have any history of skin problems? Yes. No.
	If you answered yes to the above, please provide as much detail as you can.For example what skin problems did / do you have? For how long? How are your dealing with these problems?

Comments:

Payment Policies The initial appointment consultation fee ($40) MUST be paid prior to your appointment. In order to confirm this appointment you MUST prepay the $40 consultation fee within 48 hours of it being booked. The simplest way to do this is to call in a Visa or MasterCard - leaving your name, card type, number and expiry date. If this is not done within 48 hours your appointment will be made available to others. If you decide to have a treatment done the $40 consultation fee will be deducted from the cost of your first treatment. (This does not apply to initial treatments less than $250). Treatment Fee payment is required when booking the treatment. This can be done in person, by cash, (not cheque), or by Visa or Mastercard (over the phone if you wish). If this is not done within 48 hours of making your appointment, your appointment will be made available to others. Be sure to give at least 24 hours notice to make any changes to your appointment. You may do this by leaving a phone message at our office - 613-544-0200. The system is active 24 hours a day and provides a date / time stamp. You may also contact us by email via the website at www.kingstoncosmeticinstitute.com/contactframe.htm. Remember that there is no refund for appointment cancellations, no shows or failure to provide 24 hours notice of appointment changes. Also, please remember that there is a maximum of 60 days after your initial appointment that you can rebook without forfeiting your payment, provided you have given 24 hours notice. If you have any questions about this, please contact us.
I have read and understood the "Payment Policies" as described above. Yes. No. (Answer Required)
I am a Canadian Citizen. Yes. No. (Answer Required) Our insurance regulations only allow us to treat Canadian Citizens.

A confirmation package will be emailed to you within 48 Hours.

Security

This is not a secure website! Unauthorized use of the information you submit cannot be guaranteed. The Kingston Cosmetic Institute (KCI) will not knowingly allow any use of the information you provide without your consent, however KCI assumes no responsibility whatsoever for such unauthorized usage.