Please Schedule An Appointment For Me
Please answer these questions, so we can try to find a convenient time for your appointment. If we can, we'll schedule it and email you a notification of the date and time. If we can't, we'll email you or call you- whichever method you choose below.
Are you and existing or new patient?
What is your child's first and last name?
What is your first and last name?
Which office location are you referring to?
SF Bay Area
What's your Email address, OR daytime phone number (your choice), in case we need to contact you.
How soon would you like to come in?
Whenever you have time available
As soon as possible
In two weeks
Do you prefer a particular day?
The second choice of days
Do you prefer a particular time?
Second choice of times
Please tell us any special date/ time requirements not shown above. If you would like us to make an appointment for other family members, please list the names here.
Are you a New Patient?
If you are a NEW patient at Children's Choice or would like to register someone who has never seen us before, please print out the New Patient Form below. When you have completed the form, you may upload it below, email it to us or bring it in to your next appointment.
If you would like to attach and upload any documents, please do so here.
Send me a copy of my responses
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