Patient Intake, Consent Form, and Other Handouts

 

PATIENT FORMS

Please fill in the following form prior to your visit. If you are unable to fill the form ahead of time, please arrive to your first appointment 15 minutes early to complete the paperwork.

EXTENDED HEALTH

If you have extended coverage, please inquire with your plan administrator or coverage booklet for reimbursement rates and procedures. Receipts will be provided for submitting to your extended health plan for reimbursement.

PAYMENT METHODS

Payment methods accepted at our clinic include cash, Visa, MasterCard, American Express, and debit.

CANCELLATION POLICY

24 hours advance notice is requested for canceling or rescheduling appointments. A cancellation fee may be charged otherwise.

 

CONTACT INFORMATION

#8 - 310 Goldstream Ave.,
Victoria, BC, Canada V9B 2W3

Phone: (250) 478-4057

CLINIC HOURS

Monday: 9am to 6pm
Tuesday: 12pm to 7pm
Wednesday: 9am to 1pm
Thursday: 12pm to 7pm
Friday: 9am to 1pm
Closed Saturday and Sundays

CONTACT US