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(250) 562-1305
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Request An Appointment
Please fill in the form below to request an appointment.
First Name
*
Last Name
*
Daytime Phone Number
*
Email Address
*
Birthday
*
Year
Month
Month
Day
BC Health Care Card Number
*
Preferred Appointment Date - Please note that we are booking out approximatly 2-3 weeks ahead.
*
Single choice
*
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Afternoon
Comments: (ex. reason for exam, other family members needing exams, please include birthdates)
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