Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment. Please complete the following form to request an appointment. Please also note that availability will vary depending on your request. Your appointment will be confirmed by phone by a member of our staff. Thank you!Name Phone* Email* Preferred Date* MM slash DD slash YYYY Preferred TimeMorningAfternoonEveningPreferred DoctorDr. OlgaDr. SarahDr. DawnNurse KimNature of VisitConsent* I agree to exchange text messages and receive appointment reminder texts from Integrative Medical and Complete Chiropractic Care. Text messaging may not be entirely secure. Message frequency varies. Message and data rates may apply. Reply STOP to unsubscribe or HELP for support. Check out our terms and privacy policy below.Terms and Privacy PolicyCommentsThis field is for validation purposes and should be left unchanged.