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Medical History Intake Form

519-207-LEAF (5323)

Medical History Intake Form

Medical History Intake Form

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Suzanne Leaf
Cosmetic & Wellness Centre

456 Talbot Street (rear entrance)
St. Thomas Ontario N5P 1B9

Tel:519-207-5323 (LEAF)

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HOURS:

Tuesday 10:00am - 5:00pm
Wednesday 10:00am - 5:00pm
Thursday 2:00pm - 6:00pm
Friday 10:00am - 5:00pm

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