Appointment Request 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.
Patient Type(Required)
Please let us know if you are a new or existing patient.
Name(Required)
This field is for validation purposes and should be left unchanged.

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Main Office

4009 Redford St Port Alberni, BC V9Y 3R9