Request an appointment

We're here for you.

We’re so glad you’re taking this step toward your well-being. Please complete the form below so we can best match you with the right provider and service.

Request an appointment

Insurance Information (if applicable)

Religious preference, if any

Reason for Visit / Goals

Disclaimer: I understand and agree that any information submitted will be forwarded to The Healing Centre by email and not via a secure messaging system. This form should not be used to transmit private health information, and The Healing Centre disclaims all warranties with respect to the privacy and confidentiality of any information submitted through this form. I understand that by submitting this form, I am consenting to being contacted via phone or email by The Healing Centre.

Thanks for submitting!

Please note that submitting this form does not confirm your appointment. Our team will review your request and contact you within 24–48 hours to finalize scheduling. If you selected a preferred provider, we will do our best to honor your request; however, availability may vary, and we cannot guarantee that you will see the specific provider chosen