Online Pharmaceutical Representatives' Appointment Request Form

Policy:

• Pharmaceutical Representatives will be seen by Appointment Only.
• It is not possible to see pharmaceutical representatives during practice hours except at midday in the break room, when our staff and providers take their staggered lunch breaks.
• We allow a combined maximum of 2 reps, including the manager/supervisor if present.
• No appointments will be made by phoning the clinic or showing up in person.
• Only 1 appointment per month permitted
• If you want to be sure this form will work for you, click here: test form.

This form will send an email to The Light Clinic to request an appointment slot. We will respond by email to you with available times. If email is not permitted by your company for this purpose, we will use your phone number to call- please indicate a time when the chances of reaching you on the first try are best.
Thank you.