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Book an appointment

The Environmental Health Clinic schedules appointments Monday to Friday 12:00 til 17:00. Once you have filled in this form we will contact you as soon as possible to confirm whether your requested time is available.

Preferred Date MM / DD / YYYY
Your preferred date for visiting the clinic
Alternative Date MM / DD / YYYY
An alternative date for visiting the clinic
What time works best for you?

between 12:00 and 17:00
Issues of concern

What environmental concerns would you like to discuss during your appointment?
Your Contact Information
(Im)patient Name First Last
Email *
Phone ### - ### - ####
Do Not Fill This Out

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