Appointment Request
Office hours are between 11am - 4pm ( NO WALK - INs )
In Office Consultation will attract a cost of $6000, you can make payment on the day of visit.  

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Email *
Full Name *
Phone number *
Address
Are you a new patient? *
Required
Consultation Type *
How would you like to be contacted? *
Appointment Date *
MM
/
DD
/
YYYY
Appointment Time *
Time
:
Concerns *
Additional Information
Banking Details:  
Name - Medical Specialists Ltd
Bank - National Commercial Bank
Type - Chequing Account
Location - Matildas Corner
Acc # - 372217421
NB: All payments will need to be verified before appointments can be confirmed .

- Appointments times are between 11am - 4 pm
- Please allow 24hours to confirm your appointment



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