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Monday to Friday 9:00 AM - 5:30 PM

Closed on Weekends & Holidays

FEMALE - CONSULTATION REQUEST

Please fill out this form first

First name*

Last name*

Today's Date*

Phone*

Email*

Street*

City*

Province *

Postal Code*

Date of Birth*

Age*

Health Care Number *

Do you have a Family Doctor?*

If Yes, who is your Family Doctor?*

Comments*

When was the first day of your last menstrual cycle? *

Or, date of your hysterectomy? *

Consult Fees

I understand the initial consult fee is $295, and each follow-up fee is $75 for this service.

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ABOUT US
PHARMACY & CONSULTATION SERVICES
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RESOURCES
CONTACT

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HOME
ABOUT US
PHARMACY & CONSULTATION SERVICES
PRODUCTS
RESOURCES
CONTACT

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