To book your first visit to the clinic:

If your physician hasn’t already sent a referral, please download the appropriate form below and have them fax it to us.

To self-refer:  Please note there is a $100 private non-refundable fee for self-referrals, due at the time of booking.

  • Fill in the self referral form below or
  • Contact our Referral Coordinator, Jasmin

Referral Forms

Self Referral Form