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Cobble Hill
844-382-8077
Lake Cowichan
844-382-8090
Chemainus
844-382-8111
Duncan
844-338-5480
Request an Appointment at Any of Our 4 Locations
Request an Appointment at Any of Our 4 Locations
Hours, Location & Directions
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Home » Contact Us » Appointment Request Form

Appointment Request Form

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

Complete the following form:

  • Please fill in the form below to setup an appointment.
    Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
  • Date Format: MM slash DD slash YYYY
  • :
  • This field is for validation purposes and should be left unchanged.