Appointment Request Form

Home \ Contact us \ Appointment Request Form

If this is an emergency, do not contact us via email, please use our emergency contact information.

Complete the following form:


Location Required
Doctor Required
Reason for Appointment	Appointment requests are sent to your practitioner using regular email so please do not enter confidential information.
Preferred Dates & Times Required	Check our office hours
First Name Required
Last Name Required
Telephone Required
Email
Best Time to be Reached for Confirmation Required
Comments

Locate us

162 - 164 EAST 13TH STREET
North Vancouver, BC V7L 2L5
Phone: (604) 986-9566 or (604) 984-8666
Fax: (604) 986-9574

147 - 9855 Austin Avenue - Lougheed Town Centre
Burnaby, BC V3J 1N4
Phone: (604) 420-2115
Fax: (604) 420-2177