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Waiting List Application Form

 
 
Due to the overwhelming number of new patients we have received in the last few months, we regret to inform you that we are not taking any new patients. However, if you wish to be on the patients’ waiting list, we will contact you once there is an opening. Please be reminded that it may take more than 3 months before we can contact you.
Please got to contact form and click “waiting list” if you wish to be on the waiting list.

Waiting List
If you wish to be on the waiting list, please send with the following information
– Days and time which you are available
– Your purpose of treatment (eg, fertlity treatment, shoulder pain, etc)
For example, if you can only come on Sunday afternoon, let us know so that we can inform you when your desired slots are open.

    Your Name(*)
    Phone Number(*)
    Email(*)
    Symptom(*) Fertility TreatmentBreechOthers
    If others, then please explain
    your reason for receiving treatment
    Please tell us days and time
    which you are available and
    if you have other inquiries

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