Hard to say without some idea where you are, but it was not hard for me. It did cost me a few hundred $ overall, but the process was fairly simple. It did take a few months to get a spot for a remote appointment (if I lived in the city it would be faster in person) And I just knew the clinic knew who they're dealing with (reminder sent a week and a day before, reminder sent about payment, reminder about a followup, etc.) Maybe try finding some group which may have experience / specific contacts in the area? There's bound to be a country/state-specific group online where you can ask.