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 Fax: (250) 478-4644
CLINIC HOURS
Monday: 9 a.m. to 6 p.m.
Tuesday: 12 p.m. to 7 p.m.
Wednesday: 9 a.m. to 1 p.m.
Thursday: 12 p.m. to 7 p.m.
Friday: 9 a.m. to 1 p.m.
Saturday: Closed Sunday: Closed Stats: Closed