Once you have selected the appropriate date, please enter the following information:
*Required Fields
Parent Last Name: *
Address: (Local Address) *
Phone Number: * ( ) -
Email Address: * Used for appointment reminders, confirmation and rescheduling.
Please enter the following information for each child you wish to register:
If you have previously scheduled an appointment and you are rescheduling your appointment, please select the "Reschedule Appt" at the top of the page.
If you are more than 15 minutes late for your appointment time, you will be considered a walk-in and may have to wait or reschedule.
Pin Number: * Please choose a 4 digit unique number that will be required when making a change to your appointment.