Name
*
Preferred Day:
*
Please Select
Monday
Tuesday
Wednesday
Thursday
Friday
Preferred Time Period
*
Please Select
Early morning 7:30-9am
Mid morning 9-11.30am
Midday Noon - 2pm
Mid afternoon 2.30-4pm
Late afternoon 4:30-6pm
Evening 6:30-7:30pm
E-mail:
*
Mobile:
*
Dexa Scan Sydney at City Clinic
Call DSS direct on
02 9304 5083
Should be Empty: