Register ONLINE

Please fill out the registration form below IN FULL. Please only select ONE TIME SLOT for an appointment. Please ARRIVE ON TIME and do not come early. Your registration will not be confirmed by phone unless there are clarifications required by our office.

COVID-19 & Respiratory Clinic Registration

Registration for appointment for COVID-19 testing and respiratory assessment
  • Doctor or Nurse Practitioner
  • Please select a reason you require a COVID-19 test
  • Please select all that apply:
  • Please select ONE TIME SLOT ONLY - Do not select multiple days.
  • Please select ONE TIME SLOT ONLY - Do not select multiple days.
  • Please select ONE TIME SLOT ONLY - Do not select multiple days.
  • Please select ONE TIME SLOT ONLY - Do not select multiple days.
  • Please select ONE TIME SLOT ONLY - Do not select multiple days.