Request an appointment

To request an appointment online please complete the form below

We will endeavour to contact you as soon as possible in relation to your preferred time.

As you are probably aware its not always possible to get the exact time you request but we will do our best to fit you in.
 
If you have a preferred location and provider please select these also.

We also offer a Saturday clinic at our Colombo Street clinic 9am - 12pm with our On Call physiotherapist - please select this option when making your request

 

 
Full Name:              *required  
 
Date of Birth  *required  
     
Email:  *required  
 
Phone: * required  
 
Preferred Day or Date    
     
Preferred Time  
(Please give a range of times that suit) 		 
     
Preferred Location PS @ Colombo Street             Preferred Provider          
  PS @ Cityfitness Moorhouse - Currently Closed due to Earthquake- REOPENING FEB 2013
  PS @ Pioneer                           Preferred Provider         
  PS @ Moorhouse Medical       Preferred Provider         
  PS @ Northwood                       Preferred Provider         
  PS @ Kaiapoi                            Preferred Provider         
  PS @ Riccarton                         Preferred Provider        
   PS @ Doctors On Cashel       Preferred Provider        
  Saturday Clinic                         Colombo Street Only 9am - 12  
     
ACC Related  
     
New Patient or Returning Patient    New Injury or Return Visit        
   
     
Your  Comments:  
   
 
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