Diagnostics reservation request

Completing the questions below will help us serve you even faster and more focused in scheduling your appointment. It gives us insight into your medical history and situation so we can provide you with tailored education in preparation for your appointment.

Note: Answering “yes” to a question does not automatically mean that you cannot come into care with us. We will discuss your situation over the phone to better understand the context, including in conjunction with the information from your referral letter. So it is important that you answer the questions below honestly.