Please note, our Request Appointment form is simply a request. We will do our best to accommodate the date and time that works for you.

Patient Forms

Services & Conditions

Otherwise, please arriveĀ 15 minutesĀ prior to your first appointment to complete a questionnaire and patient medical history information.

Before you leave, make sure that you have completed and turned in your Patient Portal Authorization to the receptionist. You can have access to your medical information through our secure online portal.

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Select Category
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Select Service
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Duration: {{ service_details.bookingpress_service_duration_val }} {{ service_details.bookingpress_service_duration_label }}

Price: {{ service_details.bookingpress_service_price }}

Advance Options
See Less
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View More View Less
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Date & Time
Time Slot
There is no time slots available
Morning
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Afternoon
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Evening
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Night
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Date & Time
Time Slot
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Morning
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Afternoon
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Evening
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Night
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Basic Details
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Summary

Your appointment booking summary

Customer
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{{ appointment_step_form_data.form_fields.customer_firstname }} {{ appointment_step_form_data.form_fields.customer_lastname }}
{{ appointment_step_form_data.form_fields.customer_email }}
Service
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{{ cart_details.bookingpress_service_name}}
{{extras_details.bookingpress_extra_name }}
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{{extras_details.bookingpress_selected_qty}}
{{appointment_step_form_data.bookingpress_selected_extra_service_count}} Extras
Date & Time
{{ appointment_step_form_data.selected_date | bookingpress_format_date }}, {{appointment_step_form_data.selected_formatted_start_end_time}}
{{ appointment_step_form_data.selected_date | bookingpress_format_date }}
{{ appointment_step_form_data.selected_date | bookingpress_format_date }} - {{appointment_step_form_data.selected_end_date | bookingpress_format_date}}
Appointment Details
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{{extras_details.bookingpress_extra_name }}
{{extras_details.bookingpress_extra_price}} {{extras_details.bookingpress_extra_duration}}
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{{appointment_step_form_data.bookingpress_selected_extra_service_count}} Extras
{{ appointment_step_form_data.selected_date | bookingpress_format_date }}, {{ appointment_step_form_data.selected_formatted_start_end_time }}
{{ appointment_step_form_data.selected_date | bookingpress_format_date }}
{{ appointment_step_form_data.selected_date | bookingpress_format_date }} - {{ appointment_step_form_data.selected_end_date | bookingpress_format_date }}
{{ cart_details.bookingpress_service_name}}
{{ cart_details.bookingpress_selected_date | bookingpress_format_date }}, {{ cart_details.formatted_start_end_time }}
{{ cart_details.bookingpress_selected_date | bookingpress_format_date }} - {{ cart_details.bookingpress_selected_end_date | bookingpress_format_date }}
{{ cart_details.bookingpress_selected_date | bookingpress_format_date }}, {{ cart_details.formatted_start_time }} to {{ cart_details.formatted_end_time }}
{{ cart_details.bookingpress_selected_date | bookingpress_format_date }}
{{ cart_details.bookingpress_selected_date | bookingpress_format_date }}, {{ cart_details.formatted_start_time }} - {{ cart_details.formatted_end_time }}
{{ cart_details.bookingpress_selected_date | bookingpress_format_date }}
{{ cart_details.bookingpress_selected_date | bookingpress_format_date }}, {{ cart_details.formatted_start_time }}
{{ cart_details.bookingpress_selected_date | bookingpress_format_date }}
{{subtotal_text}}
{{ appointment_step_form_data.selected_service_price }}
{{tax_title}}
Tax
+{{ appointment_step_form_data.tax_amount }}
{{couon_applied_title}} {{ appointment_step_form_data.coupon_code }}
-{{ appointment_step_form_data.coupon_discount_amount_with_currecny }}
{{coupon_code_title}}

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{{ appointment_step_form_data.total_payable_amount_with_currency }}
{{ appointment_step_form_data.selected_service_price }}
{{deposit_heading_title}}
{{deposit_title}} {{full_payment_title}}
{{deposit_paying_amount_title}}
{{ appointment_step_form_data.bookingpress_deposit_amt }}
{{ appointment_step_form_data.deposit_payment_amount_percentage }}% ( {{ appointment_step_form_data.bookingpress_deposit_amt }} )
{{deposit_remaining_amount_title}} {{ appointment_step_form_data.included_tax_label }}
{{ appointment_step_form_data.included_tax_label }}
{{ appointment_step_form_data.bookingpress_deposit_due_amt }}
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{{subtotal_text}}
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{{tax_title}}
Tax
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-{{ appointment_step_form_data.coupon_discount_amount_with_currecny }}
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{{deposit_heading_title}}
{{deposit_title}} {{full_payment_title}}
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{{ appointment_step_form_data.bookingpress_deposit_total_with_currency }}
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There is no payment method available.
Select Payment Method

Pay Locally

PayPal

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No categories and services added!

Services and Conditions

  • Diabetes
  • Endocrine Disorders
  • Cancer Screenings
  • Skin DisordersĀ 
  • Weight Loss
  • Musculoskeletal Disorders
  • Cardiovascular Disease
  • Pulmonary Disorders
  • Echocardiogram
  • Holter MonitorĀ 
  • Nuclear Stress Test
  • Coronary Angiogram
  • Electrical CardioversionĀ 
  • Pacemaker
  • Acute Respiratory Infections
  • Asthma
  • Bronchitis
  • Chest Pain
  • Fatigue
  • High Blood Cholesterol and Triglycerides
  • Hypertension (High Blood Pressure)
  • Hypothyroidism
  • Influenza
  • Menopause
  • Migraine
  • Osteoarthritis
  • Osteoporosis
  • Pnemonia
  • DOT Exam
  • OpioidĀ Dependence
  • SuboxanneĀ Treatment
  • Pacemaker ClinicĀ