Wait list - Integration Kinesiology

Integration Kinesiology Wait List

To be added to the IK waiting list, please provide the following information. When an appointment opens up that matches your criteria, we will call the number provided below.

Name(Required)

First Last

Phone number you can be reached at to receive calls when an appointment becomes available.(Required)

Email(Required)

Appointment Type:(Required)

Adult (first-time appointment)

Adult (follow-up appointment)

Child (first-time appointment)

Child (follow-up appointment)

Indicate preferred days: (select all that apply)(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

If you have any additional information you'd like to leave us about your request, please do so here:

Name

This field is for validation purposes and should be left unchanged.

APPOINTMENTS

Integration Kinesiology Wait List