Appointments

Appointment/Registration Request

Daytime appointments are available Monday through Friday from 9am-6pm.

Referrals from your medical practitioner and other health services professionals are welcome, but not necessary.

To make an appointment please use the online form below.  All contact and services are kept confidential.

Name: *
Address:
E-mail: *
Cell:
-
Ok for us to leave a message?:
Other phone:
-
Ok for us to leave a message?:(1)
Occupation:
Date of birth:
Referred by:
Family physician's name:
Insurance company:
Is direct billing available?:
Requested Service
Preferred practitioner:

Please provide more information about the services you are interested in:

Abuse:
Addiction:
Workplace:
Other areas of practice:
Additional Information:
Word Verification:
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