Appointment Request BFG Medical Clinic can be reached during normal business hours by phone. If you have a medical emergency, please dial 911. If this is an emergency, do not contact us via email, please use our emergency contact information. Appointment Request Form Firstname: * Initials * Phone number * Email Address * Date * (Example: 04/23/2017 mm/dd/yyyy) Time Morning Afternoon Evening Subject * Preferred Response * Email Telephone We will like to know if you would prefer to be contacted by e-mail or phone TERMS AND CONDITIONS * To use the electronic messaging system I am aware that my personal details may not be fully secure. I hereby take full responsibility for sending this message and completely absolve BFG Medical Clinic and all it's affiliated parties of all liabilities and responsibilities.