Contact us

The Memory Clinic specializes in the screening, assessment, and research of Alzheimer’s disease. We support individuals aged 50 and over who have concerns about memory problems, helping to promote early detection. Our team works closely with those affected, offering additional support such as research programs.

    Interested in participating? Let us know!

    I am filling out this form for:*

    Your Information:

    First Name:* Last Name:* Phone Number:*
    Email:*
     Relationship to the person for whom the application is being completed:*
    First Name:*
     Last Name (at birth):*

    Gender:*

    Please specify:*

    Date of birth:*

    Street Address:*

    Phone Number:*
     Email:*

    Are you currently taking any medication for Alzheimer’s disease?:*

    Please specify:*

    Which clinic would you like to be contacted by? :*

    How did you hear about us?:*

    Please specify:*

    I would like to receive the Memory Clinic newsletter:

    Is the appointment request for you?

    Yes, it is for me.
    No, I am applying for another person.

      Please complete the form below.

      Gender :

      Date of birth:

      Do you consent to receive email communications from us?

      Address :

      What is the reason for your appointment?

      Which clinic would you like to be contacted by?

      How did you hear about us?

        Information of the person completing the application: (we will ask for the patient’s information below)

        Which clinic would you like to be contacted by?

        Information of the person for whom the application is being completed :

        Gender :

        Date of birth:

        Do you consent to receive email communications from us?

        Address :

        What is the reason for the appointment?

        How did you hear about us?

        All our services are confidential and free of charge. You don’t need a doctor’s referral to come see us.

        *Your consultation request will only be sent to members of our team and will be treated confidentially. No information will be sent to your primary care physician or included in your medical record without your prior consent.

        While filling out this online request is the best way to reach us, you can also contact one of our clinics during our business hours.

        Montreal

        1300, rue Sherbrooke Ouest, 2nd floor, Montréal, QC H3G 1H9

        Monday to Friday 9:00 am to 4:00 pm

        (514) 400-3903

        receptionmontreal@thememoryclinic.ca

        Ottawa

        1600 Carling Avenue, Suite 100, Ottawa, ON K1Z 1G3

        Monday to Thursday 8:30 am to 4:30 pm
        Friday 8:30 am to 12 pm

        (613) 702-1000

        receptionottawa@thememoryclinic.ca