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If you want to schedule a medical or dental appointment, do not use this form. Please click here to make these types of appointments.

Request the Following Kinds of Appointments Here
  • HIV / STD / Pregnancy Testing 
  • Health Insurance Enrollment Assistance 
  • Food Assistance Enrollment SNAP
  • Case Management / Health Home

Use the short form on the right to leave us your contact information to request an appointment. 

Make sure to select the type of services you are seeking and we get back to you within two business days to schedule your visit.

Date of Birth:
Appointment Type: