Make a Booking

Please fill out this form to request an initial appointment.

Dr Chapeyama looks forward to Meeting new patients and wishes to say:

Mauya – svikai svikai titambire! Rwendo rwurefu, ngatifambe tose

(Come in, let’s get to know each other! Then we can forge a path forward together).

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First Name

Last Name

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Alternative Contact Person Name and Number

Use this to enter your phone and/or email if you are not the person needing the appointment.

Disclaimer

I understand this form is used primarily to arrange and prioritise appointments and should not be used for clinical inquiries. I understand the information provided may be retained even if no appointment is attended. Please contact info@drlyndarose.com.au if you wish to request the removal of your information.

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