Use this form to request an appointment outside of normal clinic hours. Please enable JavaScript in your browser to complete this form.Please select the applicable requested appointment type. *Request Out-of-Hours consult: for appointments earlier or later on a normal Tuesday or Wednesday clinic day - $190Request Special Booking consult: for appointments between Thursday - Monday when clinic is normally closed - (Thu-Mon) - $250Request Holiday consult: for appointments during posted vacation times incl. public holidays - $325Requested time/date: *Please give the date/s and times requested. Please also be specific as "anytime" or "asap" is not a workable request.Your reason for seeking a special consultation: *I am limited by work or other obligations.Pain and debilitation. I want/need to come in as soon as I can.I am only available at a specific time.Your (client's) full name as known by the clinic: *(Please write your name as you're known to me - no nick-names please?)Your best contact number (to receive SMS (text) communications regarding this request: *If your request can be accommodated, offers are sent by text in the first instance, so please include and double check your mobile number.NameSubmit
