Instructions for Our Clinic Agencies

After logging in the system via your Clinic Agent username and password, click "Calendar", and then follow the steps.

* If you would like to change a client for the particular time slot of a scheduled clinic day, just reserve another client on the same time slot. The old client will be automatically replaced.

* If you would like to remove a client, please repeat the steps. After selecting the particular time slot of a scheduled clinic day, click "Clear" located on the left side of "Back | Logout" on the bottom of this web page. The original client is removed.

Download the "Clinic Report" in Excel format

 

Client Referral from Non-Clinic Agencies

 
First Name
:
(Client's)
Last Name
:
(Client's)
Phone
:
   (Client's or Referee's)
Email
:
(* Must Report; Client's or Referee's)
Postal Code
:
Gender
:
Education
:
Ethnicity
:
Description
:
(approx. 50 words)
Civil Type
:
* (Must Report if Civil)